It is now well established that sleep Disorders especially sleep apnea is very prevalent across the world. There is a high likelihood they are going to ignored in these testing times where everyone is focused on dealing with the pandemic, this shall be counter productive as likely worse the chronic disease burden of individuals and the society.

It is therefore imperative that these sleep services continue to provide uninterrupted services around the world. This may need making adjustments and innovations to ensure safety and security of the patients as well as that of the sleep professionals. It is important to note that most sleep services have strict infection control protocols and procedure in place and this part of regulatory requirements.

As every country, region, hospital and service is coming with their own set of recommendations we are sharing some general suggestions that the sleep services can follow to tide over this period.

It is critical for every Sleep Labs and healthcare department to ensure the personal safety of Sleep Technicians and avoid cross-infection, In this article we describe the systematic strategies to combat COVID-19 that can arise from Home based sleep study and from the perspective of personnel going to sleep labs to perform their sleep scoring activities, including personnel arrangements, environmental modification, protection levels and configurations, Sleep Study procedures, and disinfection methods.

Here are few points listed below to help technologists avoid SARS-CoV-2 infection:

• Creating a screening check List- Every patient attending the service should be asked about any history of recent travel, any history of contact with a patient of Covid 19 or any flu like symptoms. In case of these risk factors patients may need to screened for Corornavirus before the service is provided.
• Using online/digital medium- This pandemic has provided the perfect push towards these platforms and these have found acceptance with all stake holders: patients/doctors/insurers/regulatory bodies. Sleep Medicine is perfectly suited to benefit from this as it generally has minimum physical examination needs. This can be great way to reducing the risk of transmission while maintaining continuity of service.
• Monitoring Staff health- It is critical that staff takes a proactive approach towards their health and wellbeing. They should be advised not to come to work even if they have slightest of symptoms. Access should be provided to them to be tested in that condition and appropriate provisions of leave should be made for them.
• Focusing on Insomnia- Since sleep apnea has been the engine of the specialty for last many decades most services are focused on that. A global emergence of mental health issues is inevitable with insomnia related issues becoming very common. Sleep services may look at incorporating insomnia management services to drive more work.
• Switching to Self-administered home-based sleep studies- Over the last years there has been a global push towards home sleep studies. While there are limitations with the pathway it still suits a vast percentage of patients thus services should look at switching or incorporating these in their services.
• Modifying and disinfecting the sleep lab– Feasibility of detaching the sleep lab area from centralized conditioning should be explored. This will minimize the risk of transmission. Strict disinfection procedure and protocols will need to be instituted
• Using disposable sensors– wherever able possible disposable sensors should be used to monitor different sleep parameters. When this Is not possible strict disinfection measures should be instituted.
• Trimming operations and reducing costs & exposure- this may be the perfect time to explore ways of reducing the avenues of exposure and trimming your costs but exploring avenues of outsourcing the sleep scoring and analysis to experienced providers.

Sleepcure Solutions hope this Strategy will help colleagues safely combat the virus and keep staff safe.

Symptoms and Preventions of COVID-19 an infographic