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.