COVID-19-related changes in outpatient CPAP setup pathways for OSA are linked with decreased 30-day CPAP usage

Chris D Turnbull; Martin Allen; Jennifer Appleby; Richard Brown; Nathalie Bryan; Ann Cooper; Brendan G Cooper; Cathie Gillooly; James Davidson; Hannah Farley; Ana Gaspar; Gillian Gibbons; Beverley Gray; Graham Hill; Adrian Kendrick; Blake Marsh; Alison McMillan; Joseph Page; Justin Charles Thane Pepperell; Tim Quinnell; Chris Rogers; Jane Sexton; Naomi Sheperd; Joerg Steier; James Stockley; John Stradling; Asia Woroszyl; Sophie West; Susan Wright; Annabel Nickol

doi:10.1136/thoraxjnl-2021-218635

COVID-19-related changes in outpatient CPAP setup pathways for OSA are linked with decreased 30-day CPAP usage

Thorax. 2022 May 9:thoraxjnl-2021-218635. doi: 10.1136/thoraxjnl-2021-218635. Online ahead of print.

Authors

Chris D Turnbull^{1

2}, Martin Allen³, Jennifer Appleby⁴, Richard Brown⁵, Nathalie Bryan³, Ann Cooper³, Brendan G Cooper⁶, Cathie Gillooly⁷, James Davidson⁸, Hannah Farley⁴, Ana Gaspar⁹, Gillian Gibbons¹⁰, Beverley Gray⁷, Graham Hill¹¹, Adrian Kendrick¹², Blake Marsh¹³, Alison McMillan⁹, Joseph Page⁸, Justin Charles Thane Pepperell⁸, Tim Quinnell¹⁴, Chris Rogers¹¹, Jane Sexton⁴, Naomi Sheperd⁸, Joerg Steier^{5

15}, James Stockley⁶, John Stradling^{13

2}, Asia Woroszyl⁵, Sophie West¹⁶, Susan Wright⁸, Annabel Nickol^{13

17}

Affiliations

¹ Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK christopher.turnbull@ouh.nhs.uk.
² Nuffield Department of Medicine, University of Oxford, Oxford, UK.
³ Sleep and Ventilation Service, University Hospital North Midlands, Stoke on Trent, UK.
⁴ Medical Sciences Division, University of Oxford, Oxford, UK.
⁵ Lane Fox Respiratory Unit/Sleep Disorders Centre, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
⁶ Lung Function & Sleep (QEHB Site), University Hospital Birmingham, Birmingham, UK.
⁷ Respiratory Medicine, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK.
⁸ Respiratory Medicine, Musgrove Park Hospital, Taunton, UK.
⁹ Respiratory Medicine, The Lister Hospital Sleep Service, East and North Hertfordshire NHS Trust, Stevenage, UK.
¹⁰ OSA Partnership, Bristol, UK.
¹¹ Sleep Apnoea Trust Association, Bristol, UK.
¹² University Hospitals Bristol and Weston NHS Foundation Trust & Department of Physiology, University of Bristol, Bristol, UK.
¹³ Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
¹⁴ Respiratory Support and Sleep Centre, Royal Papworth Hospital, Cambridge, UK.
¹⁵ CHAPS, Faculty of Life Sciences and Medicine, King's College London, London, UK.
¹⁶ Newcastle Regional Sleep Centre, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
¹⁷ Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK.

PMID: 35534153
DOI: 10.1136/thoraxjnl-2021-218635

Abstract

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.

Keywords: COVID-19; Non invasive ventilation; Sleep apnoea.