10 July 2025
An exciting new study aims to determine if an app delivering behavioural therapy, including group support and education, could help patients with obstructive sleep apnoea who struggle with using their continuous positive airway pressure (CPAP) machine.
Led by Dr Amanda Sathyapala, consultant respiratory physician at Royal Brompton and Harefield hospitals, and associate professor at Imperial College London, the study is funded by the Medical Research Council (MRC) to the value of almost £2.3 million.
Obstructive sleep apnoea and the problem with treatment adherence
Sleep apnoea is a condition where breathing stops and starts while sleeping. The most common type is called obstructive sleep apnoea (OSA) and is when the walls of the throat relax and narrow or close during sleep.
OSA affects approximately 8 million people in the UK, and if left untreated can lead to broken sleep which can impact quality of life. It also increases the risk of developing several conditions such as diabetes, high blood pressure and heart attacks. If patients with OSA drive, others are placed at risk by increasing the risk of road traffic accidents.
Currently, the most effective treatment for OSA is a device called a CPAP machine which works by gently pumping air into a mask that is worn over the face while sleeping.
Unfortunately, many patients with OSA find it difficult to adhere to using the CPAP machine, with approximately 62% of patients not using the machine enough to benefit them, according to a recent study led by Dr Sathyapala’s group.
Pilot work undertaken by Dr Sathyapala and her team indicates that patients feel NHS staff have insufficient time to help them when they have difficulties with their CPAP machine.
Other research studies have demonstrated that behavioural therapies that, for example, increase a patient’s confidence or motivation in using the machine through face-to-face group cognitive behavioural therapy, are the most effective type of intervention at improving patient use of CPAP.
However, these therapies are too expensive to be adopted across the NHS and impractical as there is insufficient staffing for the patient volume.
This is where Dr Sathyapala and her team come in.
Developing the app
This new study aims to build on previous work undertaken by Dr Sathyapala where she invented and co-developed a behavioural and educational intervention to improve CPAP adherence. The intervention was developed with input from 650 patients with OSA from the Hope2Sleep Charity.
Dr Sathyapala now aims to develop an app called ‘CPAP Buddy’ to deliver the intervention, which would be given to patients when they start CPAP treatment.
The first part of the project will involve working closely with a patient involvement group and developers to create a user-friendly app. This will be followed by refining the intervention with NHS patients until they find the app acceptable and helpful. In the final stage of the project, the app-based intervention will be tested against the current standard of care.
Dr Sathyapala believes the app will enable more patients with digital devices to become adherent to CPAP and will reduce burden on NHS staff so their time can be freed for other tasks, including supporting patients without digital devices.
On receiving the funding Dr Sathyapala said:
“We are delighted to have this sizable award to fund the full study, from product development through to completion of the feasibility study. We are also really pleased to be in partnership with one of the three largest global manufacturers of CPAP devices and consumables, Fisher and Paykel Healthcare who have provided a contribution of £100,000 to the total award.
“The funding comes at the perfect time as this year we have published data showing that there six different groups of patients based on their CPAP-usage behaviour. Therefore, for the first time, interventions specifically tailored for patients can be provided by our app for each group.
“Should the app be effective and cost effective the potential patient benefit is huge. Poor CPAP adherence is an issue globally, not just in the UK, so this is a huge number of people that could benefit from our app. At the moment, we are filling a gap where there is no real alternative developed or being developed.”
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