Murase Kimihiko, Lyons Owen D
Department of Medicine, Women's College Hospital, 76 Grenville St, Toronto, ON M5S 1B2 Canada.
Women's College Research Institute, Toronto, Canada.
Sleep Biol Rhythms. 2023 Jan 21;21(3):309–317. doi: 10.1007/s41105-023-00447-3. eCollection 2023 Jul.
Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, there has been a reduction in patient uptake of in-person care, likely in part, due to patients' fear of contracting COVID infection. We aimed to examine changes in the proportion of patients assessed in a sleep clinic who subsequently underwent in-lab polysomnography before and during the pandemic. A retrospective study was conducted, comparing the periods September 2018-April 2019 (pre-pandemic) and September 2020-April 2021 (pandemic). Among the patients who were referred to an ambulatory sleep clinic in Toronto, Ontario for assessment of possible sleep apnea, the number of patients who underwent diagnostic PSG within 90 days from the first consultation with a physician was analyzed. Significantly lower number of patients underwent PSG in the pandemic than the pre-pandemic period [122/229 patients (53.3%) vs. 169/208 patients (81.3%), < 0.001]. Older age and having a consultation in the months of full-blown pandemic, which was defined as month with its average of newly confirmed COVID-19 positive cases in Ontario > 1000 cases/day, were associated with declining PSG in the pandemic period. Among patients who underwent PSG, sleep apnea was found in 114/169 (67.5%) and 85/122 (69.7%) patients in the pre-pandemic and the pandemic period, respectively ( = 0.69). During the pandemic, there was a dramatic reduction in uptake of in-lab PSG. It is very likely that a significant proportion of patients in this cohort had sleep apnea that went undiagnosed with significant implications for health outcomes.
自2019年冠状病毒病（COVID-19）大流行开始以来，患者接受面对面护理的情况有所减少，这可能部分是由于患者担心感染COVID-19。我们旨在研究在睡眠诊所接受评估的患者中，在大流行之前和期间随后进行实验室多导睡眠监测的比例变化。进行了一项回顾性研究，比较了2018年9月至2019年4月（大流行前）和2020年9月至2021年4月（大流行期间）这两个时间段。在安大略省多伦多的一家门诊睡眠诊所被转诊以评估可能的睡眠呼吸暂停的患者中，分析了从首次与医生咨询起90天内接受诊断性多导睡眠图（PSG）检查的患者数量。大流行期间接受PSG检查的患者数量显著低于大流行前时期[122/229例患者（53.3%）对169/208例患者（81.3%），<0.001]。年龄较大以及在大流行全面爆发的月份（定义为安大略省新确诊COVID-19阳性病例平均每天>1000例的月份）进行咨询，与大流行期间PSG检查减少有关。在接受PSG检查的患者中，大流行前和大流行期间分别有114/169（67.5%）和85/122（69.7%）的患者被发现患有睡眠呼吸暂停（=0.69）。在大流行期间，实验室PSG检查的接受率大幅下降。很可能该队列中有很大一部分患者患有未被诊断出的睡眠呼吸暂停，这对健康结果有重大影响。
