P214 Remote monitoring in the early stages of continuous positive airway pressure (cpap) initiation in obstructive sleep apnoea (osa) allows early detection of poor compliance and mask problems

THORAX(2017)

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摘要
Background OSA is an increasingly recognised disease and successfully treated with CPAP. There are ever increasing demands on sleep services in the UK, in terms of provision, compliance and safety. One possible solution is the use of remote monitoring soon after CPAP set-up to determine usage patterns, residual apnoea-hypopnoea index (AHI) and mask problems. We have analysed our remote monitoring database to assess new patients with OSA set-up on CPAP. Method Retrospective data was collected from patients with OSA commenced on CPAP from start of June 2017 for thirty days. All patients referred to the Aintree University Hospital Sleep service had a cardio-respiratory sleep study and subsequently, if appropriate, referral for CPAP. All patients with OSA were commenced on a Resmed Airsense S10 device with humidification, using a predictive algorithm, and had an assessment for an appropriate interface. All data was collected with patient consent using Resmed Airview. Results Data was available in 71 patients (male 70%) for at least two weeks within this time period. Mean CPAP usage was 5 hours 4 mins with 84.5% using full face masks. Mean Residual AHI was low at 8.5 with small numbers of residual central events recorded (Table 1). See Table for more details Conclusion Remote monitoring provides a large amount of useful data which can potentially help improve CPAP provision in the UK. There is large proportion of patient with nocturnal hypoventilation, and despite effective treatment with CPAP, a group with a residual increase in AHI. Non-compliance and mask leak are identified issues and twenty patients used CPAP for less than an hour a night, with seven of those not at all. Remote monitoring allows early detection of non-compliance and an opportunity for earlier intervention to improve management in this patient group
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