top of page

Personalised Sleep Medicine what does it mean for Clinicians and Patients

The evolution of Continuous Positive Airway Pressure (CPAP) devices to treat sleep apnoea has witnessed remarkable advances over the past four decades, moving from basic devices to more sophisticated devices capable of personalising therapy.

This evolution has been driven by advances in technology and the increasing demand for CPAP therapy as the prevalence of Sleep apnoea is now estimated to affect 1 billion people globally (1).

There have been numerous publications on the subject of personalised sleep medicine that represent a transformative shift in this speciality. The importance of considering individualised approaches to optimising sleep health takes account of endotypic and phenotypic traits such as considering diverse factors like genetic predisposition, lifestyle habits, environmental factors, and underlying health conditions (2-3).

Despite the introduction of new mask designs over this time adherence to CPAP therapies did not improve and CPAP adherence remains a significant challenge in treating OSA, with adherence rates typically ranging from 40-80%. While mask design improvements have aimed to address some of the key issues affecting adherence, the impact on overall adherence rates appears to be modest so far.

Telemonitoring and improved adherence

The introduction of telemonitoring has shown promising results in improving CPAP adherence rates (4):

  • Improved adherence: Studies have demonstrated that remote monitoring can increase CPAP usage and adherence rates.

  • Early intervention: Remote monitoring allows healthcare providers to identify and address issues quickly, potentially preventing treatment abandonment.

  • Data-driven care: Sleep medicine clinicians can make more informed decisions based on real-time CPAP usage data.

  • Patient engagement: Some remote monitoring systems include patient apps, which can increase awareness and motivation.

  • Cost-effectiveness: Remote monitoring may reduce the need for in-person visits, potentially lowering healthcare costs., and is environmentally friendly.

Here is an overview of this evolution:

Early CPAP Devices (1980s)

Colin Sullivan, was an Australian physician, who invented the first nasal continuous CPAP machine for treating sleep apnea in 1981 and this landmark paper is published in the Lancet (3). Founded in 1982, SEFAM France developed Europe's first commercially available CPAP device in 1984 (5). The early CPAP devices were were bulky, and noisy, and they lacked advanced features and were designed to deliver a fixed air pressure to stop the airway collapsing during sleep. They had meters in side to record the hours of use. The field of sleep medicine has seen significant innovation in more recent years:

Improved CPAP Devices (1990s-2000s)

Between the 1990s to 2000s, the CPAP devices footprint became smaller quieter, and incorporated features like ramp and comfort modes to improve patient adherence to therapy. Some key advancements included:

  • Automatic adjustment of air pressure (Auto-CPAP) based on breathing patterns

  • Humidification systems to prevent oro-nasal dryness

  • Data recording capabilities to track usage and efficacy via data card downloads

Arrival of Telemonitoring and Remote Management (2000s-2010s)

With advancing technology at the turn of the millennium, CPAP device manufactures began incorporating telemonitoring capabilities, allowing healthcare providers to remotely monitor patient adherence and therapy efficacy. This enabled better management of sleep apnea treatment, oversight of adherence and improved patient outcomes.

Personalised Sleep Medicine (2010s-present)

Personalised medicine is the delivery of a patient-centred approach that takes into account an individual's unique biological characteristics to optimise their healthcare through tailored prevention strategies, early diagnosis, and targeted therapies, rather than a one-size-fits-all model (2-3).

Personalised Sleep Medicine has evolved over time and this approach recognises that sleep disorders have diverse individual presentations taking into account endotypic and phenotypic trait. Personalised sleep medicine aims to develop customised interventions and therapies to optimise sleep health for each individual (2-3). Adopting a personalised sleep medicine approach within this speciality supports best practice recommendations from recent research and takes into account the diverse presentations of this important condition that impacts on the individuals morbidity and mortality and any existing multi-morbidities .

Research using telemonitoring data has helped identify several distinct phenotypes in sleep apnea patients. Some key phenotypes include:

a) Positional sleep apnea: Patients whose apnea events occur primarily when sleeping in certain positions, often on their back.

b) REM-related sleep apnea: Patients who experience more severe apnea during REM sleep stages.

c) Chronic vs. intermittent sleep apnea: Distinguishing between patients with consistent nightly symptoms and those with more variable patterns.

d) Upper airway resistance syndrome: Identifying patients with increased respiratory effort but without clear apnea or hypopnea events.

In recent years, CPAP devices have become even more sophisticated, with a focus on personalised sleep medicine. Some key developments include:

  • Advanced algorithms for automatic pressure adjustment based on individual breathing patterns

  • Bluetooth connectivity for seamless data transfer and integration with mobile apps

  • Connected devices (e.g., oximeters, blood pressure monitors, activity trackers, weighing scales) for self-management and real-time adjustments

  • Cloud-based data storage and analysis for personalised treatment optimisation

These advancements have made CPAP therapy more comfortable, effective, and tailored to individual needs, promoting better adherence and improved sleep quality.

CPAP devices have evolved from basic air delivery systems to highly advanced, personalised, and connected devices that enable remote monitoring, self-management, and optimised treatment for people with sleep apnoea.

Over the coming 5 weeks Sefam UK will be posting a series of blogs regarding the Sleep apnoea and the impacts of co-morbid conditions on people diagnosed with this condition. We will also focus on the delivery of Personalised Sleep Medicine and why this is important for clinicians and patients.

  1. Week one will cover:

Why does Personalised Sleep Medicine matter.

2. Week two will cover:

Sleep apnoea and Cardiovascular and Cerebrovascular disease

3. Week three will cover:

Sleep apnoea and obesity/type 2 diabetes

4. Week four will cover:

Sleep apnoea and heart rate variability and exercise

5.Week five will cover:

Connected devices and how they can support the delivery of more personalised sleep medicine healthcare

Follow our series of blogs on our website

or our Sefam UK LinkedIn page


bottom of page