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. 2021 Jan 1;17(1):79-87.
doi: 10.5664/jcsm.8830.

The impact of the COVID-19 pandemic on sleep medicine practices

Karin G Johnson  1   2 , Shannon S Sullivan  3 , Afua Nti  4 , Vida Rastegar  5 , Indira Gurubhagavatula  6   7
Affiliations

The impact of the COVID-19 pandemic on sleep medicine practices

Karin G Johnson et al. J Clin Sleep Med. .

Abstract

Study objectives: The COVID-19 pandemic required sleep centers to consider and implement infection control strategies to mitigate viral transmission to patients and staff. Our aim was to assess measures taken by sleep centers due to the COVID-19 pandemic and plans surrounding reinstatement of sleep services.

Methods: We distributed an anonymous online survey to health care providers in sleep medicine on April 29, 2020. From responders, we identified a subset of unique centers by region and demographic variables.

Results: We obtained 379 individual responses, which represented 297 unique centers. A total of 93.6% of unique centers reported stopping all or nearly all sleep testing of at least one type, without significant differences between adult and pediatric labs, geographic region, or surrounding population density. By contrast, a greater proportion of respondents continued home sleep apnea testing services. A total of 60.3% reduced home sleep apnea testing volume by at least 90%, compared to 90.4% that reduced in-laboratory testing by at least 90%. Respondents acknowledged that they implemented a wide variety of mitigation strategies. While no respondents reported virtual visits to be ≥ 25% of clinical visits prior to the pandemic, more than half (51.9%) anticipated maintaining ≥ 25% virtual visits after the pandemic.

Conclusions: Among surveyed sleep centers, the vast majority reported near-cessation of in-laboratory sleep studies, while a smaller proportion reported reductions in home sleep apnea tests. A large increase in the use of telemedicine was reported, with the majority of respondents expecting the use of telehealth to endure in the future.

Keywords: COVID-19; polysomnography; sleep centers; telemedicine.

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Conflict of interest statement

All authors have seen and approved the manuscript. Work for this study was performed at Baystate Medical Center, Springfield, MA. The authors report no conflicts of interest.

Figures

Figure 1
Figure 1. Date of laboratory closure or > 90% reduction in testing by region.
Figure 2
Figure 2. Sleep study screening, setup, and processing mitigation strategies.
(A) In-laboratory sleep study screening mitigation strategies implemented or expected to be implemented due to COVID-19 (n = 292). (B) Home sleep apnea testing (HSAT) setup mitigation strategies implemented due to COVID-19 (n = 244). (C) HSAT processing mitigation strategies implemented due to COVID-19 (n = 224). PCR = polymerase chain reaction, PPE = personal protective equipment.
Figure 3
Figure 3. Sleep clinic mitigation strategies.
Figure 4
Figure 4. Estimated percentage of virtual clinic visits before and after COVID-19.
Figure 5
Figure 5. Reopening within the next month.
Expected types of testing to be offered upon reopening and COVID-19 status needed to proceed with testing.
See this image and copyright information in PMC

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