A New mHealth application to support treatment of sleep apnoea patients

Abstract

Introduction Continuous positive airway pressure (CPAP) is the first-choice treatment for obstructive sleep apnoea (OSA), but adherence is frequently suboptimal. Innovative, patient-centred interventions are, therefore, needed to enhance compliance. Due to its low cost and ubiquity, mobile health (mHealth) technology seems particularly suited for this purpose. We endeavoured to develop an mHealth application called "APPnea," aimed at promoting patient self-monitoring of CPAP treatment. We then assessed the feasibility and acceptability of APPnea in a group of OSA patients. Methods Consecutive OSA patients used APPnea for six weeks. APPnea gave patients daily reminders to answer three questions about their OSA treatment (CPAP use, physical activity, and diet) and prompted them to upload their body weight weekly. Answers were saved to a secure server for further analysis. After completing the study, patients gave their anonymous opinions about APPnea. Results We enrolled 60 patients with OSA receiving CPAP treatment. The mean age was 56 ± 10 years and the apnoea-hypopnea index was 47 ± 25 events/hour. In total, 63% of participants completed the daily questionnaire for more than 66% of the study period. Objective CPAP compliance was generally high (5.3 ± 1.6 hours/night). In a subset of 38 patients naïve to CPAP, those who used APPnea regularly had significantly higher CPAP compliance. Satisfaction levels were high for the majority of users. Conclusion This mHealth intervention is not only feasible but also satisfactory to patients. Although larger randomized trials and cost-effectiveness studies should be performed, this study shows that APPnea could promote participation and improve compliance among patients with OSA, thereby improving outcomes.

An Update on Behavioural Interventions for Improving Adherence with Continuous Positive Airway Pressure in Adults

“…Individualised health tracking through the use of Webbased and smartphone apps is likely to play a more prominent role in delivering future CPAP interventions and in providing behavioural feedback and measuring effectiveness, with online CBT shown to be effective in the treatment of insomnia [86]. Recently, severe OSA patients who regularly used a mobile health technology app BAPPnea^aimed at promoting self-monitoring of treatment had higher CPAP adherence [87]. Studies addressing the choice of interventions that best match individual patient needs/characteristics are likely to be more effective and cost efficient.…”

Mobile health application to support CPAP therapy in obstructive sleep apnoea: design, feasibility and perspectives

“…Several clinical trials have demonstrated the feasibility of telemedicine-based OSA management compared with a more traditional, in-person care model, suggesting noninferiority in terms of adherence to CPAP treatment [7], CPAP compliance [8] as well as functional outcomes such as satisfaction [9] and cost-effectiveness [10,11]. In our previous experience using telemedicine for OSA management, we found positive feedback with videoconference and mobile health (mHealth) interventions [12,13]. We also conducted a telemedicine-based strategy for CPAP follow-up which was as effective as standard hospital-based care in terms of CPAP compliance and symptoms improvement, as well as lower costs [11].…”

The role of telemedicine and mobile health in the monitoring of sleep-breathing disorders: improving patient outcomes

“…SleepMapper also helped those patients who struggled early with therapy compared with patients who did not use the app. In keeping with these findings, Isetta et al 8 designed, developed, and tested a novel App called AppNea, which aimed to promote self-monitoring of CPAP therapy in patients with OSA. They included 34 patients with diagnosed OSA, and asked them to use AppNea for 6 weeks while receiving CPAP treatment.…”

“…7 Therefore, a major challenge for sleep specialists is optimizing patient compliance, especially when initiating treatment, yet overloaded sleep units have trouble providing such support because of a lack of financial resources. 8 TH has the potential to deliver effective and convenient care that can improve compliance and patient satisfaction, and reduce absenteeism to attend specialist sleep centers. 9 We thus performed a systematic review of the published literature on the role of telemedicine compared to routine face-to-face care for monitoring and improving outcomes in patients with OSA receiving CPAP therapy, with special consideration to phone calls, videoconferencing, e-mails, websites, mobile texting, and mobile applications.…”