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

Johnson, Karin G; Sullivan, Shannon S; Nti, Afua; Rastegar, Vida; Gurubhagavatula, Indira

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 healthcare 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 (HSAT) services. A total of 60.3% reduced HSAT 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%) anticipate 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 HSATs. 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.