Introduction Obstructive sleep apnoea syndrome (OSAS) is common and UK sleep services are under considerable pressures. Adopting telephone consult based follow up supported by 2-way remote monitoring of CPAP treatment via a cloud-based system, with usage and treatment problem alert algorithms may achieve service efficiencies, rationalise patient travel for follow up, and improve treatment quality and outcomes.

Methods In February 2017, our clinical physiology team selectively adopted 2-way remote monitoring and telephone consult follow up for initiation of auto-titrating CPAP (Airsense 10 and Airview system, ResMed) for definite or suspected OSAS, prioritising those living distant from our hospital. Data from 61 patients who had completed follow up by June 2017 was retrospectively reviewed.

Results After monitoring period and telephone consult follow up (typically requiring 15 min of clinician time), 44 of 61 patients were benefiting from and using CPAP therapy ongoing. Remote monitoring review triggered remote therapy adjustment in 9 patients and day-case follow up of 7 patients. 16 patients required humidifier or alternative interface posted to them. CPAP trial was concluded with no symptomatic benefit in 8 patients. 7 patients were non-compliant and non-contactable: CPAP unit return was requested. Single telephone consultation was achieved in 27 patients; 18 patients required a 2nd call and 12 3 or more calls to make contact. 54 outpatient visits (median residence distance from hospital of 31 miles) were avoided, saving 3498 total travel miles.

Conclusions Adoption of 2-way remote monitoring facilitated telephone follow up of auto-CPAP initiation within a busy sleep service is feasible. Early treatment outcomes match our existing audit data for face-face follow up. Follow up hospital attendance was avoided in the majority of patients, with improvements in patient travel requirements. Remote monitoring facilitated recognition and intervention for early CPAP problems, which should in future translate into improved outcomes. Structured approach to telephone consultation and use of other communication methods should further improve service efficiency.