• Kimihiko Murase, Takuma Minami, Satoshi Hamada, David Gozal, Naomi Takahashi, Yoshinari Nakatsuka, Hirofumi Takeyama, Kiminobu Tanizawa, Daisuke Endo, Toshiki Akahoshi, Yasutaka Moritsuchi, Toru Tsuda, Yoshiro Toyama, Motoharu Ohi, Yasuhiro Tomita, Koji Narui, Naho Matsuyama, Tetsuro Ohdaira, Takatoshi Kasai, Tomomasa Tsuboi, Yasuhiro Gon, Yoshihiro Yamashiro, Shinichi Ando, Hiroyuki Yoshimine, Yoshifumi Takata, Akiomi Yoshihisa, Koichiro Tatsumi, MomomuraShin-IchiSISaitama Citizens Medical Center, Saitama, Japan., Tomohiro Kuroda, Satoshi Morita, Takeo Nakayama, Toyohiro Hirai, and Kazuo Chin.
• Department of Respiratory Care and Sleep Control Medicine.
• Chest. 2022 Dec 1; 162 (6): 137313831373-1383.

BackgroundTelemonitoring the use of CPAP devices and remote feedback on device data effectively optimizes CPAP adherence in patients with OSA.Research QuestionCan expanding the scope of telemonitoring and remote feedback to body weight (BW), BP, and physical activity enhance efforts for BW reduction in Patients with OSA receiving CPAP?Study Design And MethodsParticipants were recruited from patients at 16 sleep centers in Japan with OSA and obesity who were receiving CPAP therapy. Obesity was defined as a BMI of ≥ 25 kg/m2, based on Japanese obesity guidelines. Implementation of CPAP telemonitoring was enhanced with electronic scales, BP monitors, and pedometers that could transmit data from devices wirelessly. Participants were randomized to the multimodal telemonitoring group or the usual CPAP telemonitoring group and were followed up for 6 months. Attending physicians provided monthly telephone feedback calls to the usual CPAP telemonitoring group on CPAP data obtained remotely. In the multimodal telemonitoring group, physicians additionally encouraged participants to reduce their BW, after sharing the remotely obtained data on BW, BP, and step count. The primary outcome was set as ≥ 3% BW reduction from baseline.ResultsOne hundred sixty-eight participants (BMI, 31.7 ± 4.9 kg/m2) completed the study, and ≥ 3% BW reduction occurred in 33 of 84 participants (39.3%) and 21 of 84 participants (25.0%) in the multimodal telemonitoring and usual CPAP telemonitoring groups, respectively (P = .047). Whereas no significant differences were found between the two groups in the change in office and home BP, daily step counts during the study period were significantly higher in the multimodal telemonitoring group than in the usual CPAP telemonitoring group (4,767 steps/d [interquartile range (IQR), 2,864-6,617 steps/d] vs 3,592 steps/d [IQR, 2,117-5,383 steps/d]; P = .02) INTERPRETATION: Multimodal telemonitoring may enhance BW reduction efforts in patients with OSA and obesity.Trial RegistryUMIN Clinical Trials Registry; No.: UMIN000033607; URL: www.umin.ac.jp/ctr/index.htm.Copyright © 2022 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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