Feedback from Naturalistic Driving Improves Treatment Compliance in Drivers with Obstructive Sleep Apnea.

As part of a study in drivers with obstructive sleep apnea (OSA), we conducted a randomized clinical trial to assess whether individualized feedback can increase compliance with continuous positive airway pressure (CPAP) therapy. After completing 3.5 months of naturalistic driving monitoring, OSA drivers were randomized either to receive an intervention, which was feedback regarding their own naturalistic driving record and CPAP compliance, or to receive no such intervention. In the week immediately after the intervention date, drivers receiving feedback (n=30) improved their CPAP usage by an average of 35.8 minutes per night (p=0.008; 95% CI=9.6, 62.0) to a mean level of 296 minutes. By contrast, CPAP usage in the non-feedback group (n=36) decreased an average of 27.5 minutes per night (p=0.022; 95% CI=4.0, 51.0) to a mean level of 236 minutes. The mean group-specific changes were higher (better) in the feedback group than in the non-feedback group during the first, second, and third weeks of follow-up (p<0.001, p=0.001, and p=0.027, respectively). By weeks 4 through 10, the effect of the feedback had lost its significance (p>0.25 in all cases). Our study suggests that CPAP compliance can be increased using individualized feedback, but that follow-up feedback sessions or reminders may be necessary for sustained improvement.