Sleep Disordered Breathing Diagnosis and Treatment During the COVID-19 Pandemic: A Nationwide Survey in China

Abstract

Background and Objective: The coronavirus disease 2019 (COVID-19) pandemic has markedly impacted the distribution of medical resources and healthcare delivery systems. The objective of this study was to investigate the influence of the pandemic on the diagnosis and treatment of sleep-disordered breathing (SDB) in China. Methods: A retrospective online survey of sleep centers from the assembly of SDB of the Chinese Thoracic Society was conducted from July 1 to July 20, 2020. The questionnaire focused on four main aspects: 1) general information about the centers; 2) changes in SDB management activities, including patient volumes, diagnostic and positive airway pressure (PAP) titration procedures, and follow-up methods, from February to June 2020, compared with before; 3) the application of telemedicine and sleep specialists’ self-assessments of knowledge and their perspectives on telemedicine; and 4) changes in medical staff active in sleep services during the pandemic compared with before. Results: Fifty-three (96%) of the sleep centers responded to the survey. During the early stage of the outbreak, SDB medical services were dramatically reduced to 5– 10% of the pre-epidemic level, and laboratory-based polysomnograms and manual titration were almost cancelled. With the subsidence of COVID-19, SDB medical services gradually resumed to approximately half of the pre-pandemic level by June. However, a second wave of COVID-19 in Beijing significantly reduced the recovery of SDB services. The application of polygraphy has increased significantly. Home-initiated PAP and telemedicine still accounted for a small part of SDB management during the pandemic. Conclusion: The COVID-19 pandemic has greatly challenged SDB management in China. Polygraphy played a major role in SDB diagnosis during the pandemic. Home-based SDB management and telemedicine have not been well implemented. The second surge of COVID-19 in Beijing cut back on the recovering SDB service to the early outbreak level, which may give us an impetus to restructure our sleep health service.