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COVID-19-related changes in outpatient CPAP setup pathways for OSA are linked with decreased 30-day CPAP usage
  1. Chris D Turnbull1,2,
  2. Martin Allen3,
  3. Jennifer Appleby4,
  4. Richard Brown5,
  5. Nathalie Bryan3,
  6. Ann Cooper3,
  7. Brendan G Cooper6,
  8. Cathie Gillooly7,
  9. James Davidson8,
  10. Hannah Farley4,
  11. Ana Gaspar9,
  12. Gillian Gibbons10,
  13. Beverley Gray7,
  14. Graham Hill11,
  15. Adrian Kendrick12,
  16. Blake Marsh1,
  17. Alison McMillan9,
  18. Joseph Page8,
  19. Justin Charles Thane Pepperell8,
  20. Tim Quinnell13,
  21. Chris Rogers11,
  22. Jane Sexton4,
  23. Naomi Sheperd8,
  24. Joerg Steier5,14,
  25. James Stockley6,
  26. John Stradling1,2,
  27. Asia Woroszyl5,
  28. Sophie West15,
  29. Susan Wright8,
  30. Annabel Nickol1,16
  1. 1 Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
  2. 2 Nuffield Department of Medicine, University of Oxford, Oxford, UK
  3. 3 Sleep and Ventilation Service, University Hospital North Midlands, Stoke on Trent, UK
  4. 4 Medical Sciences Division, University of Oxford, Oxford, UK
  5. 5 Lane Fox Respiratory Unit/Sleep Disorders Centre, Guy's and St. Thomas' NHS Foundation Trust, London, UK
  6. 6 Lung Function & Sleep (QEHB Site), University Hospital Birmingham, Birmingham, UK
  7. 7 Respiratory Medicine, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
  8. 8 Respiratory Medicine, Musgrove Park Hospital, Taunton, UK
  9. 9 Respiratory Medicine, The Lister Hospital Sleep Service, East and North Hertfordshire NHS Trust, Stevenage, UK
  10. 10 OSA Partnership, Bristol, UK
  11. 11 Sleep Apnoea Trust Association, Bristol, UK
  12. 12 University Hospitals Bristol and Weston NHS Foundation Trust & Department of Physiology, University of Bristol, Bristol, UK
  13. 13 Respiratory Support and Sleep Centre, Royal Papworth Hospital, Cambridge, UK
  14. 14 CHAPS, Faculty of Life Sciences and Medicine, King’s College London, London, UK
  15. 15 Newcastle Regional Sleep Centre, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
  16. 16 Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
  1. Correspondence to Dr Chris D Turnbull, Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; christopher.turnbull{at}


The COVID-19 pandemic changed continuous positive airway pressure (CPAP) setup pathways. We evaluated patients commenced on CPAP in 2019 (prepandemic) and 2020 (post-first UK wave). Face-to-face (F2F) setup numbers, with CPAP turned on, decreased from 613 patients (98.9%) in 2019, to 6 (1.1%) in 2020. In 2020, setups were F2F without CPAP turned on (403 (71.1%)), or remote (158 (27.9%)). Prepandemic median CPAP usage at first follow-up was 5.4 (2.7–6.9) hours/night and fell by 0.9 hours/night (95% CI 0.5 to 1.2, p<0.0001) in 2020. We found clinically relevant reductions in CPAP usage with pathway changes post-COVID-19.

  • COVID-19
  • Sleep apnoea
  • Non invasive ventilation

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  • Contributors The study was conceived and conducted by all authors. Data and statistical analysis, literature search, and initial manuscript preparation was performed by CDT. All authors reviewed and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests CDT declares consulting fees from Bayer, outside the scope of this work. GG declares grant funding from ResMed UK and travel expenses from Wychwood Communications Limited, both outside the scope of this work. There are no other relevant conflicts of interest.

  • Provenance and peer review Not commissioned; externally peer reviewed.