Using Telemedicine to Improve Veteran Sleep Apnea Care
Using Telemedicine to Improve Veteran Sleep Apnea Care
Obstructive sleep apnea (OSA) is highly prevalent in the Veteran population given the risk
 factors of male gender, being overweight, and increasing age. OSA is caused by upper airway
 obstruction, resulting in arousals from sleep and hypoxia. While continuous positive airway
 pressure (CPAP) is a highly efficacious treatment for OSA, compliance with treatment is
 suboptimal. Because research shows that adherence patterns are established early in
 treatment, we seek to use a technology that enables early and frequent productive
 interactions between patient and provider.
Background:

 Obstructive sleep apnea (OSA) is highly prevalent in the Veteran population given the risk
 factors of male gender, being overweight, and increasing age. OSA is caused by upper airway
 obstruction, resulting in arousals from sleep and hypoxia. While continuous positive airway
 pressure (CPAP) is a highly efficacious treatment for OSA, compliance with treatment is
 suboptimal. Because research shows that adherence patterns are established early in
 treatment, we seek to use a technology that enables early and frequent productive
 interactions between patient and provider

 Objectives:

 The objective of this proposal is to explore the feasibility and initially evaluate the
 potential efficacy of a video teleconferencing system for patients with Obstructive Sleep
 Apnea syndrome (OSA) that facilitates patient- centered, collaborative management for
 patients who are prescribed the gold-standard treatment, continuous positive airway pressure
 (CPAP).

 Methods:

 The evaluative aspect of this proposal was designed as a pilot randomized, controlled
 clinical trial of Video Teleconferencing (VTC) compared to Usual Care (UC). The key feature
 of the Video Teleconferencing intervention was the use of a telemedicine system that allows
 for audio/visual conferencing with the patient in their home environment from the start of
 treatment initialization. The provider is able provide more direct feedback to the patient
 based on the telemedicine interaction, and the patient benefits from increased contact with
 the provider. Specific inclusion and exclusion criteria included: age > 18 years; confirmed
 diagnosis of moderate-severe OSA; being newly prescribed CPAP therapy; having chronic
 symptoms as noted on screening symptom checklist; and fluency in English. Patients were
 recruited from the VA San Diego Healthcare System Pulmonary Sleep Clinic. Patients were
 enrolled for a 2-month time period. Groups were compared on quantitative and qualitative
 measures.

 Status:

 Study Complete
Inclusion Criteria:

 -  Diagnosed with Moderate to Severe Sleep Apnea

 -  Live in San Diego County

 -  Veteran

 Exclusion Criteria:

 -  Previous use of positive pressure airway therapy

 -  Residence outside of San Diego county