STUDY OBJECTIVES In the context of the current COVID-19 pandemic situation, we address the following important questions: (1) How can patients be identified for possible obstructive sleep apnea (OSA) while sleep clinic testing is temporarily unavailable or limited? and (2) What measures can be suggested to improve sleep health until proper diagnosis and treatment become safe and available again? METHODS As a proxy for home or in-lab testing, validation of a symptom-based measure of OSA risk is presented, based on an on-going larger prospective study of 156 family medicine patients with OSA (88 women, 68 men; mean age 57) and 60 Control participants (36 women, 24 men; mean age 54) recruited from the community. Participants completed the Sleep Symptom Checklist (SSC) as well as a range of other self-report measures; primary care patients also underwent a polysomnographic sleep study. RESULTS Results show (a) that individuals with OSA reported more symptoms on the SSC related to Insomnia, Daytime Symptoms, Sleep Disorders and Psychological Maladjustment than the Control group (all p<.001), and (b) that their sleep-related symptoms were significantly more severe than those of Controls. In addition, (c) several PSG indices in recently diagnosed, untreated individuals with OSA were significantly correlated with SSC measured Sleep Disorder symptoms, and (d) SSC scores significantly distinguished OSA participants from Controls. CONCLUSIONS Our findings suggest that family practitioners can effectively pre-screen patients for possible OSA by inquiring about 5 items that form the SSC Sleep Disorders subscale. If OSA is suspected, there are a range of behavioral techniques which we recommend to improve symptoms. The current pandemic causes us to reflect that provisional targeting of symptoms and guidance as to mitigation strategies while waiting for specialist care could serve patients well at any time.
Impact of the COVID-19 pandemic on obstructive sleep apnea: recommendations for symptom management.