Uso de teletitulación y telemonitoreo en el seguimiento de pacientes con apnea del sueño durante la pandemia de COVID-19

Abstract

Objective: To describe the demographic characteristics, comorbidities, polygraphy parameters, remote titration, telemonitoring, and adverse effects in patients with severe obstructive sleep apnea (OSA) and a high frequency of comorbidities, managed telematically over a one-year period. As a secondary objective, to identify early risk factors for low adherence to CPAP and to assess the efficacy and safety of the telematic method. Methods: We included all patients diagnosed with severe OSA by in-hospital cardiorespiratory polygraphy between 2020 and 2021, who were remotely adjusted using an automatic positive airway pressure device for three nights and telemonitored for 360 days, collecting data related to the stated objectives. Results: A total of 53 patients were included, with a mean age of 55.6 ± 11.9 years (mostly male, 64.2%). All had a high clinical risk of OSA (StopBang > 5), excessive daytime sleepiness (Epworth > 10), and an average body mass index (BMi) of 38.3 kg/m^[1]. The median (P25-P75) baseline apnea-hypopnea index (AHI) was 50.4 (35.4-67.1). During telemonitoring, the me­dian (P25-P75) adherence was 100 (100-100), 82 (70-97), and 73 (50-89) for remote titration, 30 days, and 360 days, respectively. Conclusion: The remote titration and telemonitoring program in patients with severe OSA and a high frequency of comorbidities proved to be safe and effective in controlling respiratory events during a 360-day telemonitoring period.