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. 2021 Mar 4;57(3):2002722.
doi: 10.1183/13993003.02722-2020. Print 2021 Mar.

Sleep laboratories reopening and COVID-19: a European perspective

Affiliations

Sleep laboratories reopening and COVID-19: a European perspective

Sophia Schiza et al. Eur Respir J. .

Abstract

Clinical activities regarding sleep disordered breathing (SDB) have been sharply interrupted during the initial phase of the coronavirus disease 2019 (COVID-19) epidemic throughout Europe. In the past months, activities have gradually restarted, according to epidemiological phase of COVID-19 and national recommendations. The recent increase in cases throughout Europe demands a reconsideration of management strategies of SDB accordingly. Diagnosis of SDB and initiation of treatment pose some specific problems to be addressed to preserve the safety of patients and health personnel. This perspective document by a group of European sleep experts aims to summarise some different approaches followed in Europe and United States, which reflect national recommendations according to the epidemiological phase of the COVID-19 infection. Respiratory sleep medicine is likely to change in the near future, and use of telemedicine will grow to avoid unnecessary risks and continue to provide optimal care to patients. In addition, the document covers paediatric sleep studies and indications for titration of noninvasive ventilation, as well as precautions to be followed by patients who are already on positive airway pressure treatment. A single consensus document developed by the European Respiratory Society and national societies would be desirable to harmonise SDB management throughout Europe.

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Conflict of interest statement

Conflict of interest: S. Schiza has nothing to disclose. Conflict of interest: A. Simonds has nothing to disclose. Conflict of interest: W. Randerath has nothing to disclose. Conflict of interest: F. Fanfulla has nothing to disclose. Conflict of interest: D. Testelmans has nothing to disclose. Conflict of interest: L. Grote has nothing to disclose. Conflict of interest: J.M. Montserrat has nothing to disclose. Conflict of interest: J-L. Pepin has nothing to disclose. Conflict of interest: J. Verbraecken has nothing to disclose. Conflict of interest: R. Ersu has nothing to disclose. Conflict of interest: M.R. Bonsignore has nothing to disclose.

Figures

FIGURE 1
FIGURE 1
Flow chart summarising the screening procedures commonly adopted before access to the sleep laboratory or clinic. In phases of high coronavirus 2019 (COVID-19) transmission in the community, access to the sleep laboratory is limited to very urgent cases, and may require PCR testing.
FIGURE 2
FIGURE 2
Flow chart summarising diagnostic procedures and precautions. In phases of high coronavirus 2019 (COVID-19) transmission in the community, PCR is usually required if in-laboratory polysomnography (PSG) is considered essential for diagnosis.
FIGURE 3
FIGURE 3
Flow chart summarising positive airway pressure (PAP) titration procedures and precautions. In phases of high coronavirus 2019 (COVID-19) transmission in the community, in-laboratory titration is avoided, and may require PCR testing. PSG: polysomnography; NIV: noninvasive ventilation.

References

    1. Grote L, McNicholas WT, Hedner J, et al. . Sleep apnoea management in Europe during the COVID-19 pandemic: data from the European Sleep Apnoea Database (ESADA). Eur Respir J 2020; 55: 2001323. doi:10.1183/13993003.01323-2020 - DOI - PMC - PubMed
    1. American Academy of Sleep Medicine (AASM) . COVID-19 Mitigation Strategies for Sleep Clinics and Sleep Centers – Reopening. August 27, 2020. www.aasm.org/covid-19-resources/covid-19-mitigation-strategies-sleep-cli....
    1. Wilson KC, Kaminsky DA, Michaud G, et al. . Restoring pulmonary and sleep services as the COVID-19 pandemic lessens: from an Association of Pulmonary, Critical Care, and Sleep Division Directors and American Thoracic Society-coordinated task force. Ann Am Thorac Soc 2020; 17: 1343–1351. doi:10.1513/AnnalsATS.202005-514ST - DOI - PMC - PubMed
    1. Ayas NT, Fraser KL, Giannouli E, et al. . Helping Canadian health care providers to optimize sleep disordered breathing management for their patients during the COVID-19 pandemic. Can J Respir Crit Care Sleep Med 2020; 4: 81–82. doi:10.1080/24745332.2020.1758442 - DOI
    1. Salord N, Montserrat JM, Javier Puertas F, et al. . Unidades de sueño y consultas de ventilación mecánica no invasiva. Este apartado es un consenso entre la Sociedad Española de Neumología y Cirugía Torácica (SEPAR) y la Sociedad Española de Sueño (SES). [Sleep units and non-invasive mechanical ventilation consultations. This section is a consensus between the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and the Spanish Sleep Society (SES)]. www.drive.google.com/file/d/1oORAlJ2lW6EPsOYvTbAYWJElQrpQP_dV/view.

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