Overview of changes to routine procedures in sleep medicine during the COVID-19 pandemic

Diagnosis of sleep disordersStarting treatment for sleep disordersFollow-up of sleep disorders
Home sleep testing instead of diagnosis in the laboratoryPhone or video consultation between the patient and healthcare personnel during the initial PAP procedure instead of in-laboratory titrationPhone or video consultation instead of clinic visits
Phone or video consultation during the diagnostic work-up instead of physical meetingsMask fitting without applying airway pressureFollow-up of treatment with home sleep testing instead of in-laboratory polysomnography
Shipment of diagnostic equipment to patient’s home and back to the sleep clinicVideo-based instructions for starting PAP and/or HMV treatmentTelemedicine-based follow-up of PAP treatment by digital transfer of PAP device-based log data (adherence, AHI, leakage)
Telemedicine: remote transfer of diagnostic dataGroup start of PAP using video consultationStandard videos to support troubleshooting during PAP treatment follow-up
Probes or entire diagnostic devices for single use onlyRegular use of APAP instead of CPAP
Careful disinfection procedures for devices and equipment usedShipment of PAP devices to the patient

(C)PAP: (continuous) positive airway pressure; AHI: apnoea–hypopnoea index; APAP: auto-adaptive PAP; HMV: home mechanical ventilation.