Authors (including presenting author) :
Tang WT, Tse PY, Yip KL, Chiu PH, Chow MC, Lam YF, Lo BY, Miu PL
Affiliation :
Division of Respiratory Medicine, Department of Medicine, Pamela Youde Nethersole Eastern Hospital
Introduction :
Obstructive sleep apnea (OSA) is associated with adverse long term health consequences. CPAP is the gold standard of treatment. CPAP is conventionally started after a single-night in-laboratory titration, but patients may not use CPAP eventually due to lack of experience and confidence in handling CPAP. It comes to the introduction of Telemetric Home CPAP Titration in PYNEH since October, 2020. This is a 7-day programme including face-to-face educational classes, mask-fitting sessions, tele-monitoring and phone follow-up. Apart from obtaining the optimal pressure settings, it also functions as a first-hand experience of treatment in daily life, during which nurses will provide timely troubleshooting to tackle patients’ discomfort and queries during CPAP use at home.
Objectives :
1. To introduce the use of tele-health in Sleep Services 2. To provide a modernized and diversified CPAP titration service to facilitate patients in starting CPAP treatment
Methodology :
A retrospective analysis of patients using Telemetric Home CPAP Titration (Home titration) and In-laboratory Auto-CPAP Titration (In-lab titration) from 1/1/2021 to 30/6/2022 was performed. The inclusion criteria were as follows: 1. Diagnosed with OSA 2. New to CPAP treatment 3. Performed either a successful 1) Home Titration OR 2) In-lab Titration Patients with complicated sleep breathing disorders were excluded. The rate of patients who have started using CPAP in the first follow-up after CPAP pressure prescription were reviewed in two groups.
Result & Outcome :
Total 100 In-lab Titration and 414 Home Titration were performed. 254 patients had fulfilled the inclusion criteria (In-lab Titration: 45 patients, aged 23-75 years with median of 58 years; Home Titration: 209 patients, aged 27-87 years with median of 53 years). Median follow up are 15.4 (In-lab Titration) and 16.1 (Home Titration) weeks. 21 (46.7%) and 133 patients (63.6%) had started using CPAP in the first follow up after CPAP treatment prescription in In-lab Titration and Home Titration group respectively. Empiric studies have suggested that rates for CPAP use range from 30–60%. Telemetric Home CPAP Titration service is effective in facilitating patients’ initial CPAP use. Attended In-laboratory titrations can be reserved for patients with complicated sleep breathing disorder for better resources allocation.
