Web-Based Access to Positive Airway Pressure Usage with or without an Initial Financial Incentive Improves Treatment Use in XXXX with Obstructive Sleep Apnea.

@entity1 @entity27 @entity2786
Study Objectives: We tested whether providing adults with @entity27 ( @entity27 ) with daily Web-based access to their positive airway pressure ( @entity2786 ) usage over 3 mo with or without a financial incentive in the first week improves adherence and functional outcomes. Setting: Academic- and community-based sleep centers. @entity1 : One hundred thirty-eight adults with newly diagnosed @entity27 starting @entity2786 treatment. Interventions: @entity1 were randomized to: usual care, usual care with access to @entity2786 usage, or usual care with access to @entity2786 usage and a financial incentive. @entity2786 data were transmitted daily by wireless modem from the @entity1 ' @entity2786 unit to a website where hours of usage were displayed. @entity1 in the financial incentive group could earn up to  30/day in the first week for objective @entity2786 use >=  4 h/day. Measurements and Results: Mean hours of daily @entity2786 use in the two groups with access to @entity2786 usage data did not differ from each other but was significantly greater than that in the usual care group in the first week and over 3 mo (P < 0.0001). Average daily use (mean    standard deviation) during the first week of @entity2786 intervention was 4.7    3.3 h in the usual care group, and 5.9    2.5 h and 6.3    2.5 h in the Web access groups with and without financial incentive respectively. Adherence over the 3-mo intervention decreased at a relatively constant rate in all three groups. Functional Outcomes of Sleep Questionnaire change scores at 3 mo improved within each group (P < 0.0001) but change scores of the two groups with Web access to @entity2786 data were not different than those in the control group (P > 0.124). Conclusions: @entity2786 adherence is significantly improved by giving @entity1 Web access to information about their use of the treatment. Inclusion of a financial incentive in the first week had no additive effect in improving adherence.
