Sleep testing during the pandemic

• Published in: Sleep medicine 2023-01, Vol.101, p.375-383
• Main Authors: Powell, Adam C., Horrall, Logan M., Long, James W., Gupta, Amit K., Gitnacht, Demian
• Format: Article
• Language: English
• Subjects: COVID-19; Home-based testing; Humans; Pandemics; Polysomnography; Positive airway pressure; Sleep; Sleep Apnea Syndromes - diagnosis; Sleep Apnea Syndromes - epidemiology; Sleep Apnea Syndromes - therapy; Sleep disordered breathing; Sleep study; Sleep testing
• ISSN: 1389-9457; 1878-5506
• DOI: 10.1016/j.sleep.2022.11.008

The COVID-19 pandemic disrupted the U.S. healthcare system, reducing the capacity available for unrelated conditions, such as sleep disordered breathing, and increasing concerns about the safety of in-lab testing. This study characterizes how the pandemic impacted the assessment of sleep disordered breathing and use of associated services. Sleep testing claims occurring between January 2019 and June 2021 were extracted from the database of a national healthcare organization. Utilization was trended. Logistic regressions were run to assess the association between quarter of initial testing, whether testing was followed by treatment, and whether testing was followed by a clinical visit with a diagnosis related to sleep apnea, after controlling for patient-related factors. A Cox proportional hazards model assessed factors influencing time to treatment. Finally, a logistic regression assessed factors influencing the finality of home-based testing. In Q2 2021, home-based testing utilization was 134% of its initial level, while in-lab and split night testing were both at 61% of initial levels. Patients receiving initial home-based testing did not significantly differ in their likelihood of treatment, but were significantly less likely to have a clinical visit for sleep apnea (P