Enabling Sleep Apnea Patient-Centered Care Via an Internet Intervention

Poor treatment adherence with CPAP therapy is well-documented. Set against a backdrop of
telemedicine applications that have grown as fast in unsubstantiated claims and assumptions
of patient satisfaction, diagnostic accuracy, clinical efficacy, and cost-effectiveness as
they have in technological sophistication and capabilities, the evaluative aspect of this
proposal is designed as as a randomized, controlled clinical trial—Usual Care patients
(control) versus i-PAP patients (intervention). An important empirical-methodological
advantage of the project is the objective measurement of CPAP adherence, which is measured
by internal microprocessor as the "amount of time CPAP is used at the prescribed pressure."
This objective measurement allows feedback of treatment adherence and efficacy to both
patient and provider, and the i-PAP intervention was designed around this central feature.

Inclusion Criteria:

- age > 18 years

- confirmed diagnosis of OSA

- being newly prescribed CPAP therapy

- having chronic symptoms as noted on screening symptom checklist

- fluency in English

Exclusion Criteria:

- cognitive impairment sufficient to cause inability to complete the protocol (MMSE <
24/30)

- residence in a geographical area outside of San Diego County

- fatal comorbidity (life expectancy less than 6 months as indicated by treating
physician)

- significant documented substance/chemical abuse or other participant circumstances
that, in the opinion of a consensus of study team, would interfere with the safety of
a prospective participant or their need for treatment