Zhang Xiao Lei, Wang Wei, Xiao Yi
Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, People's Republic of China.
National Clinical Research Center for Respiratory Diseases, Beijing, People's Republic of China.
Nat Sci Sleep. 2021 Jan 8;13:21-30. doi: 10.2147/NSS.S292373. eCollection 2021.
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.
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.
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.
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.
2019年冠状病毒病（COVID-19）大流行对医疗资源的分配和医疗服务体系产生了显著影响。本研究的目的是调查该大流行对中国睡眠呼吸障碍（SDB）诊断和治疗的影响。
于2020年7月1日至7月20日对中国胸科协会SDB协作组的睡眠中心进行了一项回顾性在线调查。问卷集中在四个主要方面：1）中心的一般信息；2）2020年2月至6月期间SDB管理活动的变化，包括患者数量、诊断和气道正压通气（PAP）滴定程序以及随访方法，与之前相比；3）远程医疗的应用以及睡眠专家对知识的自我评估及其对远程医疗的看法；4）大流行期间从事睡眠服务的医务人员与之前相比的变化。
53个（96%）睡眠中心回复了调查。在疫情爆发初期，SDB医疗服务大幅减少至疫情前水平的5%-10%，基于实验室的多导睡眠图和手动滴定几乎取消。随着COVID-19的缓解，到6月SDB医疗服务逐渐恢复到疫情前水平的约一半。然而，北京的第二波COVID-19疫情显著降低了SDB服务的恢复程度。多导睡眠监测的应用显著增加。居家启动的PAP和远程医疗在大流行期间在SDB管理中仍占一小部分。
COVID-19大流行给中国的SDB管理带来了巨大挑战。多导睡眠监测在大流行期间的SDB诊断中发挥了主要作用。居家SDB管理和远程医疗尚未得到很好的实施。北京的第二波COVID-19疫情将SDB服务的恢复程度削减至疫情爆发初期水平，这可能促使我们重新构建睡眠健康服务。
