Optimizing Positive Airway Pressure Compliance and Outcomes in Rural Patients with Obstructive Sleep Apnea Through Telehealth

Jenna R. Cooper (), Kristi A. Acker, James D. Geyer, Monica M. Henderson, Randi Henderson-Mitchell and John C. Higginbotham
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Jenna R. Cooper: Alabama Neurology and Sleep Medicine, Tuscaloosa, AL 35406, USA
Kristi A. Acker: School of Nursing, The University of Alabama, Tuscaloosa, AL 35401, USA
James D. Geyer: Alabama Neurology and Sleep Medicine, Tuscaloosa, AL 35406, USA
Monica M. Henderson: Alabama Neurology and Sleep Medicine, Tuscaloosa, AL 35406, USA
Randi Henderson-Mitchell: Institute for Rural Health Research, College of Community Health Sciences, The University of Alabama, Tuscaloosa, AL 35401, USA
John C. Higginbotham: Research Institute of Pharmaceutical Sciences, The University of Mississippi, Oxford, MS 38677, USA

IJERPH, 2025, vol. 22, issue 4, 1-18

Abstract: Introduction: Telehealth approaches have demonstrated benefits in improving positive airway pressure (PAP) compliance in patients with obstructive sleep apnea (OSA), improving access to healthcare resources, and improving health outcomes for rural communities. Methods: This quality improvement (QI) pilot study implemented weekly telemedicine visits for four weeks of PAP therapy in rural patients newly diagnosed with OSA. Epworth Sleepiness Scale (ESS) scores were compared prior to and at one month of therapy. PAP compliance was compared between rural patients who received the telemedicine intervention and a group of patients not receiving the telemedicine intervention. Results: Compliance rates were higher in the intervention group. There was not a significant difference in compliance for the intervention group (M = 63.22, SD = 32.78) versus the control group (M = 46.40, SD = 36.24), t (46) = 1.69, p = 0.099. ESS scores were significantly greater prior to one month of therapy (M = 8.38, SD = 5.70) compared to after one month of therapy (M = 2.83, SD = 2.65), t (23) = 5.22, p < 0.001, d = 1.07. Discussion: This QI pilot study utilized telemedicine to remove barriers to care, improve PAP compliance, and improve health outcomes for this underserved, rural population.

Keywords: obstructive sleep apnea (OSA); positive airway pressure (PAP) compliance; rural setting; telehealth; sleep medicine; telemedicine; health education programs; rural health networks (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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