Telemetric Assessment of Continuous Positive Airways Pressure (CPAP) Effectiveness and Adherence in Obstructive Sleep Apnea during COVID-19 Pandemic

Abstract

Obstructive sleep apnea is the most common sleep-related breathing disorder. In the pandemic times of the new coronavirus SARS-CoV-2, CPAP (Continuous Positive Airway Pressure) therapy of obstructive sleep apnea became even more challenging. After the pandemic outbreak in March 2020, most CPAP treatment recommendations changed because of rising concerns about CPAP usage safety for patients and their families. Therefore, we examined the effectiveness of CPAP and adherence to the therapy of 149 adults with obstructive sleep apnea in the period of two years from 4 March 2019 to 3 March 2021 (before pandemic breakout and during the first year of pandemic). Data on CPAP parameters and adherence to therapy were obtained via a telemetric system. Together, our results demonstrated that the COVID-19 pandemic had no significant impact on CPAP therapy parameters and adherence in whole study group. However, detailed analysis acknowledged that some demographic and clinical features influenced CPAP therapy. The results showed that across subgroups of patients differentiated on the basis of age, gender, co-existing diabetes mellitus, or hypertension, the COVID-19 pandemic seemed to affect CPAP effectiveness. Our results provide a good starting point for discussion on CPAP therapy recommendations during pandemic times.

Impact of the COVID-19 pandemic on adherence to positive airway pressure treatment in patients with obstructive sleep apnea: systematic review and meta-analysis

“…We screened 225 articles and identified 13 potentially eligible articles ( Figure 2 ). After full-text review, 10 observational before-and-after studies 8 – 17 met our inclusion criteria. No relevant randomized controlled trials were found.…”

“…13 In contrast, research conducted in Turkey 14 showed a decrease in adherence, whereas no difference was reported in studies in the US state of Massachusetts, 15 Thailand, 16 and Poland. 17 Instead of enforcing a national lockdown -the strictest enforcement of physical distancing and one that was frequently implemented by Western countries -the Korean government enacted social distancing on 22 March 2020 to control COVID-19 transmission. 18 In this study, we evaluated the impact of the COVID-19 pandemic on adherence to PAP therapy in patients with OSA in South Korea.…”

“… 13 In contrast, research conducted in Turkey 14 showed a decrease in adherence, whereas no difference was reported in studies in the US state of Massachusetts, 15 Thailand, 16 and Poland. 17 …”

Quality of Life, Mental Health, and CPAP Compliance in Thai Patients with Obstructive Sleep Apnea during COVID-19 Pandemic

“…This might be attributed to home isolation during the pandemic, resulting in improved sleep and continuous CPAP compliance. However, a study by Michalek-Zrabkowska et al reported that the COVID-19 pandemic had no significant impact on CPAP therapy parameters and adherence in OSA patients [ 22 ]. Additionally, a large study involving 8,477 OSA patients by Bertelli et al demonstrated that the COVID-19 pandemic had a clinically irrelevant effect on CPAP adherence for OSA treatment [ 23 ].…”