1048 Impact of Automated CPAP Tele-monitoring on CPAP Adherence At 2 Years: Follow-up From The Tele-OSA Randomized Clinical Trial

Abstract Introduction We previously reported results from the Tele-OSA study demonstrating improved 3-month CPAP adherence with CPAP tele-monitoring with automated patient feedback [U-Sleep; ResMed Corp] but no significant impact with telemedicine-delivered education [Emmi, Emmi Solutions Inc]. We performed a 2-year follow-up evaluating the continued impact of CPAP tele-monitoring(TM). Methods This 4-arm randomized clinical trial was conducted at Kaiser Permanente sleep center (Fontana, CA) studying patients referred for suspected OSA and appropriate for home sleep apnea testing; if indicated, CPAP was ordered with cellular connectivity. Patients were randomized into: 1) Traditional pathway (usual care); 2) Education pathway (usual care + web education); 3) Tele-monitoring pathway (usual care + automated patient feedback messaging via text/email/phone triggered by CPAP data); 4) Both pathway (usual care + web education and tele-monitoring). Because primary endpoint (3-month adherence) showed improvement only with CPAP TM, patients were collapsed into TM versus non-TM groups to compare 2-year adherence. Results 556 patients were prescribed CPAP (58.5% males; mean age 50.5 ± 12.1, BMI 34.5 ± 7.7, AHI 31.9 ± 25.8). There were no differences in baseline characteristics between the 2 groups. % days used for TM versus non-TM were 63.4 ± 31.2% vs 52.3 ± 34.2; p