• Monique Mendelson, Isabelle Vivodtzev, Renaud Tamisier, David Laplaud, Sonia Dias-Domingos, Jean-Philippe Baguet, Laurent Moreau, Christian Koltes, Léonidas Chavez, Gilles De Lamberterie, Frédéric Herengt, Patrick Levy, Patrice Flore, and Jean-Louis Pépin.
• Univ Grenoble Alpes, HP2 laboratory, Grenoble, France ; Inserm U1042, HP2, Grenoble, France ; CHU Grenoble, HP2, Grenoble, France.
• Sleep. 2014 Nov 1;37(11):1863-70.

Study ObjectivesObstructive sleep apnea (OSA) has been associated with hypertension, which is one of the intermediary mechanisms leading to increased cardiovascular morbidity. This study aimed at evaluating the effects of a combination of continuous positive airway pressure (CPAP) and telemedicine support on blood pressure (BP) reduction in high cardiovascular risk OSA patients.DesignA multi-center randomized controlled trial that compared standard CPAP care and CPAP care and a telemedicine intervention.SettingSleep clinics in France.Patients Or Participants107 adult (18-65 years old) OSA patients (AHI > 15 events/h) with a high cardiovascular risk (cardiovascular SCORE > 5% or secondary prevention).InterventionsPatients were randomized to either standard care CPAP (n = 53) or CPAP and telemedicine (n = 54). Patients assigned to telemedicine were equipped with a smartphone for uploading BP measurements, CPAP adherence, sleepiness, and quality of life data; in return, they received pictograms containing health-related messages.MeasurementsThe main outcome was home self-measured BP and secondary outcomes were cardiovascular risk evolution, objective physical activity, CPAP adherence, sleepiness and quality of life.ResultsSelf-measured BP did not improve in either group (telemedicine or standard care). Patients in primary prevention showed greater BP reduction with CPAP treatment than those in secondary prevention.ConclusionsCPAP treatment supported by telemedicine alone did not improve blood pressure and cardiovascular risk in high cardiovascular risk OSA patients. This study emphasizes the need for diet and physical activity training programs in addition to CPAP when aiming at decreasing cardiometabolic risk factors in these patients.Clinical Trials RegistrationClinicalTrials.gov identifier: NCT01226641.

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