Introduction: Optimizing adherence to positive airway pressure therapy (PAP) therapy, the first line treatment for OSA, remains a challenge. The COVID-19 pandemic has increased the adoption of telemonitoring among patients with OSA. However, telemonitoring services are limited in Malaysia.

 Aim:To determine the  association of telemonitoring on adherence to PAP therapy among patients with OSA.

 Method:This was a retrospective study of 235 patients with OSA who were treated with PAP therapy from January 2020 to October 2022.Patients were divided into two groups: telemonitoring (TM) and usual care (UC).TM group had their PAP data transferred via a cellular network to the cloud database (Airview, Resmed).UC group had their PAP download using memory card and troubleshooting during clinic visit.Primary outcomes were PAP usage at 30 and 90 days. Secondary outcome was changes in Epworth Sleepiness Scale (ESS) score at 30 and 90 days.

Results: 141 patients received UC while 94 received TM. There were no significant differences between both groups in age, body mass index, AHI, ESS score and distance to the hospital. TM group had higher PAP usage at 30 days (4.80 ± 2.41 hours/night vs 4.03 ± 2.39 hours/night; p=0.036) and 90 days (4.93 ± 2.61 hours/night vs 3.97 ± 2.58 hours/night; p=0.029). There was significantly higher percentage of patients adherent to treatment (> 4 hours usage/night, > 70% nights) at 90 days (68.7% vs 54.7%;p=0.018). No significant in changes of ESS score between the two groups.

Conclusion: Telemonitoring was associated with higher adherence to PAP therapy for patients with OSA.