Background:

CPAP remains the cornerstone of OSA therapy with device set-up traditionally conducted in-person. Post pandemic, this transitioned to a virtual medium and due to significant backlogs in service, the device set-up aspect was further outsourced.

Objective:
To investigate the outcomes of CPAP set-ups in the current virtual era

Methods:
A retrospective review of CPAP set-up at a sleep service was carried out. 30 patients were selected from each cohort commenced on CPAP in 2018, 2020 and 2022. The set-up methods throughout the pandemic progressed from in-person, to virtual-clinic and finally outsourced respectively. Data collected included average usage at 1 and 3 months post set-up, average device pressure (ADP) and apnoea hypopnoea index (AHI). Compliance was defined as an average usage greater than 4 hours and percentages of patients considered compliant were calculated.

Results:

Conclusion:
With the progressive virtualisation of post-pandemic healthcare, adaptation of the sleep-service was anticipated to offer an efficient solution to clearing patient backlogs.
Data collection from the 2018-cohort compared with the 2020-cohort demonstrated consistent compliance rates, however the 2022-cohort illustrated a significant reduction in compliance from the outset. The results indicate a multifactorial aetiology to compliance, highlighting the benefit of patient engagement by a consistent team. Virtual set-up was shown to not be inferior to in-person set-up. Further research is required to understand the underlying cause of inferior outcomes with outsourcing.