Guidelines of the Indian Society for Sleep Research (ISSR) for Practice of Sleep Medicine during COVID-19

• Published in: Sleep and vigilance 2020, Vol.4 (2), p.61-72
• Main Authors: Gupta, Ravi, Kumar, V. Mohan, Tripathi, Manjari, Datta, Karuna, Narayana, Manjunatha, Ranjan Sarmah, Kripesh, Bhatia, Manvir, Devnani, Preeti, Das, Sourav, Shrivastava, Deepak, Gourineni, Rama Devi, Singh, Tripat Deep, Jindal, Apar, Mallick, Hruda Nanda
• Format: Article
• Language: English
• Subjects: Biomedical and Life Sciences; Biomedicine; Coronaviruses; COVID-19; Laboratories; Medicine/Public Health; Neurology; Neurosciences; Psychiatry; Sleep apnea; Sleep disorders; Standards and Guidelines
• ISSN: 2510-2265; 2510-2265
• DOI: 10.1007/s41782-020-00097-2

Background Sleep services are assigned a non-essential status during COVID-19. The American Academy of Sleep Medicine strongly urges sleep clinicians to continue postponing non-urgent care until a later date, if such a recommendation is made by state officials due to local conditions. At the same time, one cannot ignore the fact that sleep is important for people’s health and wellbeing. Therefore, to protect the health of the population, it is essential to find ways and means to continue the practice of sleep medicine even during the COVID-19 pandemic. Method Social environment and work ethics in sleep clinics and sleep laboratories in Asia, Africa, and Latin America are different from those in the US. Under these circumstances, the Indian Society for Sleep Research (ISSR) created a task force to develop guidelines for the practice of sleep medicine, not only for the Indian environment but also for other countries that are affected by the COVID-19 pandemic. The task force examined documents regarding practice of sleep medicine and associated specialities  during COVID-19 by various professional organizations and governmental authorities. The recommendations were examined for their applicability. Wherever gaps were identified, consensus was reached keeping in view the available evidences. Outcome and Recommendations The emphasis of the guidelines is on avoiding doctor to patient contact during the pandemic. Teleconsultation and other modes of audio-visuals can be used as modes for medical practice during the COVID-19 pandemic. However, in addition to the patient, the presence of a family member, or a reliable informant is recommended. Patients of most sleep disorders can be provided tele-aftercare service. ISSR guidelines also give a list of medications allowed to be prescribed during the first and the follow-up teleconsultation. Hospitals and clinics are slowly opening in India and many other countries. As sleep services resume operations, there is a need to find innovative ways to reduce contact with COVID-19 patients, follow personal protection guidelines, as well as social distancing. This article does discuss strategies for the safe conduct of Level 1 sleep studies. Home sleep testing, which had greater acceptance during the last few years, should be given more attention during the COVID-19 period. Once the decision to reopen the sleep laboratory and resume operations is made, the safety of the patients and office staff should become the major priority