The use of telemedicine for the diagnosis and treatment of sleep disorders: an American Academy of Sleep Medicine update

Shamim-Uzzaman, Q. Afifa; Bae, Charles; Ehsan, Zarmina; Setty, Arveity R.; Devine, Michelle; Dhankikar, Swati; Donskoy, Innessa; Fields, Barry G.; Hearn, Hunter; Hwang, Dennis; Jain, Vikas; Kelley, Dennis; Kirsch, Douglas B.; Martin, William Marty; Troester, Matthew M.; Trotti, Lynn Marie; Won, Christine; Epstein, Lawrence J.

doi:10.5664/jcsm.9194

Cited by 67 publications

(27 citation statements)

References 18 publications

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“…During the pandemic, as in many other fields of medicine, physician visits, both for new and established patients in a sleep medicine practice, have often been conducted via telemedicine [ 98 , 99 ]. The American Academy of Sleep Medicine (AASM) has issued an updated position paper [ 100 ] on the use of telemedicine for assessment of patients with sleep disorders (particularly during the pandemic), suggesting that telemedicine visits may be performed in lieu of live in-person office visits if they mirror live visits in quality and process and comply with all licensing, state, federal and HIPAA regulations for both originating and distant sites, even when both sites are located outside of the traditional office. The AASM position paper also recommends special consideration for both the physical and psychological safety of the patient at the time of the telemedicine visit.…”

Section: Introductionmentioning

confidence: 99%

Sleep disorders and COVID-19

2022

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Section: Introductionmentioning

confidence: 99%

Sleep disorders and COVID-19

2022

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“…The World Health Organization (WHO), as part of its COVID-19 strategic preparedness and response plan released operational guidance on maintaining essential services during COVID-19 [ 9 ], containing recommendations for mental, neurological and substance use (MNS) disorders focusing on maintaining emergency/acute care, treatment and care in outpatient settings, residential care, cross-sectoral service delivery such as for example community services or inclusive schooling and mental and brain health promotion. Patient associations and scientific societies have also published guidelines and conducted surveys in the first months of the pandemic [ 10 , 11 ]. A rapid assessment of MNS services conducted by WHO with 130 Ministries of Health worldwide during June–August 2020 highlighted the disruption of essential MNS services in most countries [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Disruptions of neurological services, its causes and mitigation strategies during COVID-19: a global review

et al. 2021

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Background The COVID-19 pandemic leads to disruptions of health services worldwide. To evaluate the particular impact on neurological services a rapid review was conducted. Methods Studies reporting the provision of neurological services during the pandemic and/or adopted mitigation strategies were included in this review. PubMed and World Health Organization’s (WHO) COVID-19 database were searched. Data extraction followed categories used by WHO COVID-19 pulse surveys and operational guidelines on maintaining essential health services during COVID-19. Findings The search yielded 1101 articles, of which 369 fulfilled eligibility criteria, describing data from 210,419 participants, being adults (81%), children (11.4%) or both (7.3%). Included articles reported data from 105 countries and territories covering all WHO regions and World Bank income levels (low income: 1.9%, lower middle: 24.7%, upper middle: 29.5% and high income; 44.8%). Cross-sectoral services for neurological disorders were most frequently disrupted (62.9%), followed by emergency/acute care (47.1%). The degree of disruption was at least moderate for 75% of studies. Travel restrictions due to lockdowns (81.7%) and regulatory closure of services (65.4%) were the most commonly reported causes of disruption. Authors most frequently described telemedicine (82.1%) and novel dispensing approaches for medicines (51.8%) as mitigation strategies. Evidence for the effectiveness of these measures is largely missing. Interpretation The COVID-19 pandemic affects all aspects of neurological care. Given the worldwide prevalence of neurological disorders and the potential long-term neurological consequences of COVID-19, service disruptions are devastating. Different strategies such as telemedicine might mitigate the negative effects of the pandemic, but their efficacy and acceptability remain to be seen.

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“…In the case of sleep medicine, and particularly in OSA, multiple telemedicine modalities can be used, including telediagnosis, teleconsultation, and telemonitoring of patients being treated with CPAP. However, it is crucial to carefully select clinical outcomes and adequately target those patients who may benefit from telemedicine interventions [ 12 , 13 , 14 ]. Currently, and especially after experiencing a global pandemic with COVID-19, the use of telemedicine has been markedly increased.…”

Section: Introductionmentioning

confidence: 99%

“…Currently, and especially after experiencing a global pandemic with COVID-19, the use of telemedicine has been markedly increased. Telemetric monitoring of OSA patients allows remote CPAP titration [ 14 , 15 ]. Moreover, telemedicine allows that most patients can be remotely contacted (by phone or video-visits) for satisfactorily managing OSA [ 14 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Telemedicine Strategy to Rescue CPAP Therapy in Sleep Apnea Patients with Low Treatment Adherence: A Pilot Study

Garmendia

Farré

Ruı́z

et al. 2021

JCM

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Patients with sleep apnea are usually treated with continuous positive airway pressure (CPAP). This therapy is very effective if the patient′s adherence is satisfactory. However, although CPAP adherence is usually acceptable during the first months of therapy, it progressively decreases, with a considerable number of patients accepting average treatment duration below the effectiveness threshold (4 h/night). Herein, our aim was to describe and evaluate a novel telemedicine strategy for rescuing CPAP treatment in patients with low adherence after several months/years of treatment. This two-week intervention includes (1) patient support using a smartphone application, phone and voice recorder messages to be answered by a nurse, and (2) daily transmission and analysis of signals from the CPAP device and potential variation of nasal pressure if required. On average, at the end of the intervention, median CPAP adherence considerably increased by 2.17 h/night (from 3.07 to 5.24 h/night). Interestingly, the procedure was able to markedly rescue CPAP adherence: the number of patients with poor adherence (<4 h/night) was considerably reduced from 38 to 7. After one month, adherence improvement was maintained (median 5.09 h/night), and only 13 patients had poor adherence (<4 h/night). This telemedicine intervention (103€ per included patient) is a cost-effective tool for substantially increasing the number of patients with CPAP adherence above the minimum threshold for achieving positive therapeutic effects.

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The use of telemedicine for the diagnosis and treatment of sleep disorders: an American Academy of Sleep Medicine update

Cited by 67 publications

References 18 publications

Sleep disorders and COVID-19

Sleep disorders and COVID-19

Disruptions of neurological services, its causes and mitigation strategies during COVID-19: a global review

Telemedicine Strategy to Rescue CPAP Therapy in Sleep Apnea Patients with Low Treatment Adherence: A Pilot Study

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