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Study Objectives: <p>This study sought to evaluate whether telehealth setup was noninferior to in-person setup for veterans initiating positive airway pressure (PAP) therapy.</p> Methods: <p>PAP setups before and after the COVID-19 pandemic were identified at 2 Veterans Affairs health systems. Telehealth PAP setups occurred between March 2020 and December 2021. The in-person PAP setups occurred between January and December 2019. PAP data were extracted for days 1–30 (month 1) and 60–90 (month 3). PAP use was compared between in-person and telemedicine using hours used per night, days used (out of 30 days), and residual apnea-hypopnea index (among adherent users). Noninferiority analyses were performed, using the following noninferiority margins: 45 minutes for hours used, 4 days for days of usage, and 5 events/h for residual apnea-hypopnea index.</p> Results: <p>A total of 432 Veterans Affairs patients (93.5% male) who underwent PAP setup were included (224 in-person; 208 telehealth). Noninferiority was established for PAP usage at month 1 (90% confidence interval [CI] = −0.31, 0.53) and month 3 (90% CI = −0.18, 0.71), days used at month 1 (90% CI = −2.28, 1.33) and month 3 (90% CI = −1.75, 2.20), and residual apnea-hypopnea index at month 1 (90% CI = −0.40, 1.62) and month 3 (90% CI = −0.69, 2.30).</p> Conclusions: <p>Initiation of PAP therapy via telehealth was noninferior to in-person setup visits in terms of PAP adherence among veterans who use Veterans Affairs care.</p> Citation: <p>Gomez A, Sarmiento KF, Smith C, et&#xa0;al. Effectiveness of mailed versus in-person PAP initiation in the Veterans Affairs’ TeleSleep program. <i>J Clin Sleep Med.</i> 2025;21(8):1379–1387.</p>

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Effectiveness of mailed versus in-person PAP initiation in the Veterans Affairs’ TeleSleep program

  • 期刊论文

  • 发表日期：

    2025年8月1日

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  • Alexander Gomez,
  • Kathleen F. Sarmiento,
  • Connor Smith,
  • Michael Mitchell,
  • Diane Lee,
  • Annette Totten,
  • Elizabeth Sanders,
  • Armand M. Ryden,
  • Jiyeon Seo,
  • Sarathi Bhattacharyya,
  • Brian Harris,
  • Roberto Mempin,
  • Isabel Moghtaderi,
  • Yameena Jawed,
  • Nikita Jambulingam,
  • Jennifer Martin,
  • Michelle Zeidler

摘要

Study Objectives:

This study sought to evaluate whether telehealth setup was noninferior to in-person setup for veterans initiating positive airway pressure (PAP) therapy.

Methods:

PAP setups before and after the COVID-19 pandemic were identified at 2 Veterans Affairs health systems. Telehealth PAP setups occurred between March 2020 and December 2021. The in-person PAP setups occurred between January and December 2019. PAP data were extracted for days 1–30 (month 1) and 60–90 (month 3). PAP use was compared between in-person and telemedicine using hours used per night, days used (out of 30 days), and residual apnea-hypopnea index (among adherent users). Noninferiority analyses were performed, using the following noninferiority margins: 45 minutes for hours used, 4 days for days of usage, and 5 events/h for residual apnea-hypopnea index.

Results:

A total of 432 Veterans Affairs patients (93.5% male) who underwent PAP setup were included (224 in-person; 208 telehealth). Noninferiority was established for PAP usage at month 1 (90% confidence interval [CI] = −0.31, 0.53) and month 3 (90% CI = −0.18, 0.71), days used at month 1 (90% CI = −2.28, 1.33) and month 3 (90% CI = −1.75, 2.20), and residual apnea-hypopnea index at month 1 (90% CI = −0.40, 1.62) and month 3 (90% CI = −0.69, 2.30).

Conclusions:

Initiation of PAP therapy via telehealth was noninferior to in-person setup visits in terms of PAP adherence among veterans who use Veterans Affairs care.

Citation:

Gomez A, Sarmiento KF, Smith C, et al. Effectiveness of mailed versus in-person PAP initiation in the Veterans Affairs’ TeleSleep program. J Clin Sleep Med. 2025;21(8):1379–1387.