LAUSR

Remote-Patient-Monitoring(RPM) is gaining implementation but to date, nightly-monitoring of OSA other than PAP devices, has not become a standard of care. We have taken the lead on OSA-RPM and developed a platform that imports data from a FDA-approved technology based on Cardiopulmonary-Coupling software linked to a ring oximeter (SleepImage) worn at night. Last year we presented on the practicality and patient adherence of our approach. Here we are presenting our experience over the past two years of using our platform to assist in the management of a wide range of OSA treatment approaches. We developed software to manage the work-flow involved with nightly RPM of sleep. Patients wear a ring oximeter at night designed to provide data to a cloud-based platform for retrieval by our staff using our tracking software platform. Inclusion criteria: OSA with an abnormal baseline AHI. Also included are narcolepsy patients on oxybate, known to enhance OSA. Patient self-reported inputs regarding therapy are captured. Treatment approaches range from PAP (CPAP/BiLevel), Inspire-HGNS, Oral-Appliance-Therapy, Surgical-Interventions (i.e. MMA), orthodontics and combinations of the above. Since 1-1-2021, 140pts enrolled, 85 since 1/1/2022, and 87 currently monitored (12/1/2022). Ave 59yrs +/- 13, 64% Males. Discontinuation resulted for reasons ranging from clinical improvement, financial limitations, lack of compliance and other. Numerous treatment modifications have been guided without repeat NPSG/HSAT testing. OSA-RPM has influenced management of PAP, Inspire-HGNS, Oral-Appliance, orthodontics, and surgical therapies, as well as combination of the above. Detailed outcomes to be furnished. In brief, OSA-RPM with our system has provided extensive insight into efficacy of treatment approaches. Additionally, night to night variability can be better appreciated with this RPM technique, implying the limitation of single-night sleep studies. Using this approach has allowed direct ongoing assessment of the impact of therapy modifications directed by both the clinician and the patient. There are currently no established protocols or guidelines for the use of this type of OSA-monitoring. It is important that guidelines be implemented to provide an improved level of care and not abused to just increase reimbursements with little added value, as abuse could hinder the growth of this type of care.