A mobile-based daily check-in approach to monitor patient reported outcomes in obstructive sleep apnea: results from a 6-month home-based observation study.

Integrated alongside home-based passive sleep monitoring, high-frequency assessment of patient reported outcomes (PROs) could enhance both research and clinical care surrounding obstructive sleep apnea (OSA). However, traditional approaches to capturing OSA-related PROs are poorly suited for this purpose. Hence, we investigated the feasibility of a smartphone-based check-in approach to monitor daily PROs (e.g. mental, emotional, and physical) over a 6-month period in people referred for suspected OSA. We quantified and assessed change in the proportion of participants (n = 68; 54% female) who, on average, achieved an "adequate" self-report rate of ≥4 self-reports per week (out of a possible seven). Generalized additive models (GAMs) were used to investigate if OSA severity (apnea-hypopnea index; AHI) was associated with the probability of adequate initial uptake within the first two weeks, sustained engagement over time, and the probability of a self-report on any given day. Self-reports were made on 52.1% of all possible days, equating to (M ± SD) 3.6 ± 3.0 per week. Within the first week, 63.2% of participants achieved "adequate" self-report compliance; during weeks 4 and 12, these rates were 70.6% and 54.4% , respectively. Greater baseline AHI was associated with slower time-dependent decline in the probability of adequate self-report compliance in an exposure-response manner. Within-subjects, daily self-reports were more probable following nights of elevated AHI (absolute and mean-referenced). All GAM smooth terms: p < .00001. Findings demonstrate the feasibility of bi-daily PRO assessment via app-based check-ins for approximately 1 month in the context of clinical OSA and suggest that greater disease burden enhances sustained engagement with this monitoring approach. This paper is part of the Consumer Sleep Technology Collection.