Reopening Sleep Medicine Services in the Conundrum of an Ongoing COVID-19 Pandemic: A Global View

Abstract

The emergence of COVID-19 brought all healthcare services around the globe to immense strain; hospitals abandoned elective care for acute care. Like all other elective services, sleep medicine services suffered a partial deadlock due to the closing down of the sleep disorders diagnostic and therapeutic services, although clinical consultations and follow-ups, carried on remotely, allowed some mitigation. Since there is dire need to resume the services, we tried to formulate the principles and guidelines to work in this exigent healthcare setting. Principles and guidelines are based on epidemiological and infection control guidelines besides recommendations of various healthcare organizations and sleep societies, after a requisite web search to extract the data.

COVID-Somnia: How the Pandemic Affects Sleep/Wake Regulation and How to Deal with it?

“…Considering the important association between sleep and SARS-CoV-2 infection, several societies have proposed guidelines to mitigate sleep disorders and using telemedicine facilities to manage patients during the pandemic. This issue contains two papers that discuss measures to be taken to provide sleep disorder services to patients during pandemic– [ 16 , 17 ]. Readers may benefit from these guidelines, which will help them to understand, and manage sleep medicine services during the prevailing unprecedented condition.…”

Long-Term Adherence to Positive Airway Pressure Therapy in Saudi Ambulatory Patients with Obesity Hypoventilation Syndrome and Severe Obstructive Sleep Apnea: A One-Year Follow-Up Prospective Observational Study

“…Telemedicine is a potentially powerful tool in improving adherence to PAP therapy, where actual adherence can be distantly measured. 37,38 This technology may be beneficial in patients with OHS who usually have several comorbidities and have difficulties attending sleep disorders clinics.…”

Recomendaciones para la realización de estudios de sueño pediátricos durante la pandemia covid-19

“…Consideramos que nuestro quehacer medico ha tenido que adaptarse, sin olvidar que la flexibilización debe asociarse a cuidar el perfil de seguridad para nuestros pacientes. Con este articulo se pretende describir las mejores recomendaciones disponibles a la fecha, para la continuidad de apertura de los servicios de medicina del sueño, estimulando el uso de CPAP titulado en casa (Auto CPAP) (53) el uso de poligrafía ambulatoria o polisomnografia en casa y la necesidad de considerar en un futuro un «laboratorio de sueño virtual», con video asistencia, consulta en línea, estudios en casa con técnico a domicilio, entre otras opciones para resolver los problemas de sueño de niños, asegurando la mejor eficacia y adherencia (41,(53)(54)(55)(56). Lo cual se ha demostrado con el uso de teleasistencia para los pacientes con CPAP, no se debe pasar por alto el apoyo multidisciplinario para el SAHOS, y los elementos de apoyo al tratamiento como: aparatos orales o maxilares, que algunos autores plantean en esta pandemia, como primera línea de tratamiento el uso de estos elementos en apoyo con odontopediatria y cirugía maxilofacial (57,58).…”

“…Role of Intermediate Respiratory Care Units (UCRIS). Consensus between the Spanish Society of Pneumology and Thoracic Surgery (SEPAR) and the Spanish Society of Sleep (SES) (52,53,61)…”