TABLE 1

Summary of recommendations for management of patients with sleep disordered breathing according to epidemiological situation

VisitsSleep testEvaluation for COVID-19
Stage 0: maximum transmission rateTelemedicine
Phone
No sleep studies, postpone initiation of treatment
Home respiratory polygraphy in high-risk cases
Clinical
Stage 1: improvement of the pandemic situationTelemedicine
Phone
Home respiratory polygraphy (protection 1)
CPAP in high-risk patients: automatic or telematic titration
Clinical
Stage 2: trend towards normalisation of the pandemicTelemedicine
Phone
In few cases: face to face
Home respiratory polygraphy (protection 1)
PSG (protection 2)
CPAP: automatic or telematic titration (protection 1); demonstration in the laboratory (protection 2)
PCR if PSG
Protection 3 if titration in the laboratory

COVID-19: coronavirus disease 2019; CPAP: continuous positive airway pressure; PSG: polysomnography. Protection 1: FFP2 mask, nitrile gloves, surgical gown (optional glasses or plastic shield); protection 2: PSG: the technician has to be comfortable while spending all the night with the patient; PCR is needed; FFP2 mask, surgical gown, hat, gloves and glasses (optional plastic face shield). Street clothes will not be used and the hospital uniform must be changed and cleaned daily; protection 3: FFP2/3 mask, nitrile gloves, surgical gown, hat, glasses/plastic face shields. Street clothes will never be used and the work uniform must be changed daily. It is recommended not to use open masks or circuits, but to use a closed circuit with an antiviral filter, turning on the equipment only when it is connected to the patient. Reproduced and modified from [5] with permission.