Background: TM could be a good alternative to in-lab management of sleep disordered breathing (SDB).

Aim: To evaluate a TM protocol including hPAP titration in patients with SBD.

Methods: In this pilot study conducted by the Universities of Pisa and Palermo, subjects aged 18-75 years with a diagnosis of SDB were enrolled. The management model included: the sleep physician, the home care provider performing hPAP titration and follow-up (FU), and an external medical center (MC) monitoring PAP therapy alerts in TM. Patients used a dedicated App to answer questionnaires, receive alerts and contact the MC as needed. Data on mask leakage, hours of use and efficacy (apnea-hypopnea index and questionnaire scores) were available on a web platform. Patients were evaluated with videocalls at 1, 2 and 4 months and as needed. Data are reported as mean ± SD or frequency.

Results: We enrolled 30 subjects (males 61%, obese 70%, BMI 36.2 ± 8.9 Kg/m²), 25 with OSA, 4 with overlap syndrome and 1 with hypoventilation syndrome. Three patients received Bilevel and 27 Continuos PAP respirators. Five patients withdrew during titration and 1 during FU. During titration, patients used the device for 280 ± 139 min/night for a mean of 89.7 ± 16.5% of the nights, 52% used PAP for ? 4 h/night for ? 70% of the nights. After 4 months, 84.6% of patients with good compliance, and 33.3% of patient with poor compliance during titration, were adherent to treatment. Only 3% of patients were dissatisfied by this TM protocol.

Conclusions: TM is feasible in the titration phase and FU of hPAP.

FISR2020IP_02014 Project (MIUR)