Remote monitoring contribution to the continuation of CPAP treatment in the long term: which gain and for whom? A cohort analysis.

PURPOSE: The impact of remote monitoring (RM) on the likelihood of continuing CPAP therapy in apneic patients remains unknown in the long term and was addressed by a comparative cohort analysis. METHODS: The probability of continuing CPAP (pC-CPAP) was compared by log-rank test between two groups of adult patients with obstructive sleep apnea syndrome: Group A = CPAP initiated without RM between 2015 and 2016 (n = 1806); Group B = CPAP initiated with RM between 2018 and 2019 (n = 3195). CPAP discontinuations were either legitimate (LD) or forced (FD). The impact of gender and age was assessed from the hazard ratio of FDs (Cox model) and propensity coefficient matching. RESULTS: pC-CPAP at 3 years was higher if CPAP began with RM (72.3% with 95% CI = [70.8, 73.9] for group B versus 67.4% with 95% CI = [65.2, 69.6] for group A (log rank = 10,595 ; p = 0.001)). If the LD rate did not change, the risk of FD in group B decreased by 15.3% (p = 0.001), remained lower in men (p = 0.013), decreased in the age groups [31; 40] (p < 0.0001) and [41; 50] (p = 0.001). The class of age with the highest propensity to maintain CPAP was rejuvenated by a decade. CONCLUSION: These results are consistent with a benefit of RM from CPAP initiation for improving the chances of continuing CPAP in the long term with a generation-dependent gain.