Home Telemonitoring and Adjustement of CPAP Settings in Patients with Sleep Apnea

Introduction: Patients with obstructive sleep apnea (OSA) facing difficulties related to continuous positive airway pressure (CPAP) treatment, or those with severe comorbidities such as COPD, may need more than one night titration in the sleep lab to properly adjust CPAP settings. Home telemonitoring and real-time refinement of CPAP settings could be of great interest. Aim: To assess the functioning and feasibility of a telemonitoring system that allows real-time refinement of CPAP settings in OSA patients at home. Methods: The system is based on a telemetric unit operating via mobile phone networks connected to a commercially available CPAP device. The system permits two functions: online monitoring of flow, pressure and air leak signals from the CPAP device, as well as real-time adjustment of the nasal pressure of the patient. The system was tested in 5 OSA patients with COPD GOLD III-IV included in the European Project CHROMED (http://www.chromed.eu/). Results: The technician was able to successfully change the CPAP settings by using the new real-time telemonitoring system and signals were adequately received for all patients for more than 90% of the night. Less than 3 nights of home re-titration were sufficient to refine the previous prescribed pressure, which was changed in three patients. In average 15±14 residual events/night, most of them hypopneas were detected. Conclusions: The system is feasible and could be very useful for CPAP setting refinements required by complex patients at home. The potential role of this approach on difficult OSA patient, such as with COPD or those on mechanical ventilation, should be further evaluated. (Supported by Instituto de Salud Carlos III (PI14/00416).