Patient experience of the use of continuous positive airway pressure for the treatment of obstructive sleep apnea with or without telemedicine during COVID-19: a qualitative approach.

Abstract

Continuous positive airway pressure (CPAP) is considered effective treatment for moderate-severe obstructive sleep apnea (OSA). Clinicians measure compliance to treatment by the number of hours CPAP is used per 24 hours. There have been very few studies examining the patients' lived experience of CPAP and the barriers to use. This study examined the patients' experience of OSA, CPAP use and treatment during COVID-19. This CPAP patient experience qualitative study was part of a larger project. The overarching study was a three-armed nonblinded randomized controlled trial of patients on CPAP for treatment of OSA using standard care or one of two telemedicine interventions. Patients who had completed the RCT study were invited to be interviewed via telephone, about their OSA diagnosis, CPAP experiences, their experience of using telemedicine and the impact of SARS-CoV-2 (COVID-19). Fifteen patients (five from each arm of the trial) took part in a semi-structured interview. Thematic analysis identified three themes: day to day living, standard hospital care versus telemedicine management and living though COVID-19 with CPAP. All participants described significant symptoms caused by their OSA before diagnosis. While CPAP treatment was often described as challenging, patients discussed the improvement in their symptoms with treatment. There were differing opinions on virtual appointments, however the consensus was the use of telemedicine to support CPAP treatment was well received. COVID-19 appeared to have little effect on the patient experience.