Haldar Arup K, Dhar Raja, Maity Somnath, Krishnan Shyam, Bhattacharya Amrita, Sovani Milind
Department of Pulmonary Medicine, CMRI Hospital, Kolkata, West Bengal, India.
Department of Physiotherapy, Myofunctional Therapist, Institute of Sleep Sciences, Kolkata, West Bengal, India.
Lung India. 2025 May 1;42(3):186-190. doi: 10.4103/lungindia.lungindia_572_24. Epub 2025 Apr 29.
Compliance or adherence with positive airway pressure (PAP) therapy is a major issue in obstructive sleep apnea (OSA). The telemonitoring gives an opportunity to track a group of patients on cloud-based devices. In this study, we followed up patients with this cloud-based method for more than a year and followed up two different cohorts who are on continuous PAP (CPAP) and auto adjusting PAP (APAP) devices. The main objective was to judge whether one device scores over the other.
This was a retrospective study. We included 60 patients in the CPAP group and 80 patients in the APAP group in the study who are using the device for 1 year or more; they all were on cloud-based devices, and for them, we had data of completed 1 year at least. The data were reviewed periodically for compliance, AHI (Apnea-Hypopnea Index), and leak and compared.
Both the groups were matched in terms of age, BMI, and AHI. Adherence at 365 days was significantly more (P < 0.001) for CPAP than APAP. Overall adherence was not lesser than 60% for CPAP in any patient. The mean AHI was 1.48 in CPAP group and 2.30 in APAP group. When we measured the leak in CPAP versus APAP group, it was 0.53 liter/minute more in CPAP group than in APAP group, but it was statistically non-significant (P = 0.8553). The mean pressure level between APAP and CPAP was 11.11 cmH2O in CPAP group and 11.62 cm H2O in APAP group, and it was again statistically non-significant (P = 0.1960). CPAP group used the machine 5.77 hours average, while APAP group used it for 4.51 hours average.
CPAP adherence at 1 year was better over APAP in this study, which has a large cost implication.
持续气道正压通气（PAP）治疗的依从性是阻塞性睡眠呼吸暂停（OSA）的一个主要问题。远程监测为通过基于云的设备追踪一组患者提供了机会。在本研究中，我们采用这种基于云的方法对患者进行了一年多的随访，并对使用持续气道正压通气（CPAP）设备和自动调压气道正压通气（APAP）设备的两个不同队列进行了随访。主要目的是判断一种设备是否比另一种设备得分更高。
这是一项回顾性研究。我们纳入了研究中60名使用CPAP设备1年或更长时间的患者和80名使用APAP设备的患者；他们都使用基于云的设备，并且我们至少有他们完成1年的数据。定期审查数据以了解依从性、呼吸暂停低通气指数（AHI）和漏气情况并进行比较。
两组在年龄、体重指数和AHI方面相匹配。CPAP在365天时的依从性显著高于APAP（P < 0.001）。CPAP组中任何患者的总体依从性均不低于60%。CPAP组的平均AHI为1.48，APAP组为2.30。当我们测量CPAP组与APAP组的漏气情况时，CPAP组比APAP组多0.53升/分钟，但在统计学上无显著差异（P = 0.8553）。CPAP组的平均压力水平为11.11 cmH2O，APAP组为11.62 cmH2O，同样在统计学上无显著差异（P = 0.1960）。CPAP组平均使用机器5.77小时，而APAP组平均使用4.51小时。
在本研究中，CPAP在1年时的依从性优于APAP，这具有很大的成本影响。
