Electronic health record–derived outcomes in obstructive sleep apnea managed with positive airway pressure tracking systems

This study characterizes changes in certain EHR-derived outcomes within 1 year of CPAP therapy guided by adherence and AHI flow tracking data. Most notably, improvements in blood pressure occurred after initiation of CPAP (mean decrease of systolic 1.23 mm Hg and diastolic 1.01 mm Hg), with no statistically significant difference in the magnitude of improvement between the group that met adherence targets and the group that did not. Improvement in daytime peripheral oxygenation (mean increase 0.3%) was also notable, but this may be caused by factors other than CPAP usage, given the improvements occurred identically in patients meeting treatment targets and those who did not. In contrast to prior studies demonstrating weight gain, we did not find evidence for a change in weight after patients started CPAP. An unexpected increase in health care utilization, as measured by acute care visits and overall charges within the University of Utah Health system, was also found within the first year of CPAP initiation.

Our study is among the first to address the consequences of utilizing CPAP tracking downloads during routine care of patients with OSA. Despite the widespread adoption of adherence tracking guided algorithms due to presumed clinical effectiveness, there have not been studies that have validated the clinical utility of this approach to improve patient outcomes.

https://jcsm.aasm.org/doi/10.5664/jcsm.9750