1059 Effects of COVID-19 on Sleep Services Use and Its Recovery

Abstract

Listen

Translate article

Abstract Introduction The COVID-19 pandemic affected the utilization of various healthcare services differentially. Sleep testing services utilization (STU) (Home Sleep Apnea Testing [HSAT] and Polysomnography [PSG]) were uniquely affected. We assessed the effects of the pandemic on STU and its recovery using the Veterans Health Administration (VHA) data. Methods A retrospective cohort study from the VHA between 01/2019 and 10/2023 of veterans with age ≥ 50. We extracted STU data using Current Procedural Terminology codes for five periods based on STU and vaccination status: pre-pandemic (Pre-Pan), pandemic sleep test moratorium (Pan-Mor), and pandemic pre-vaccination (Pan-Pre-Vax), vaccination (Pan-Vax), and postvaccination (Pan-Post-Vax). We compared STU between intervals (Pre-Pan as the reference). Results Among 261,371 veterans (63.7±9.6 years, BMI 31.9±6.0 kg/m², 80% male), PSG utilization decreased significantly during Pan-Mor (-56%), Pan-Pre-Vax (-61%), Pan-Vax (-42%), and Pan-Post-Vax (-36%) periods all compared to Pre-Pan. HSAT utilization decreased significantly during the Pan-Mor (-59%) and Pan-Pre-Vax (-9%) phases compared to the Pre-Pan and subsequently increased during Pan-Vax (+6%) and Pan-Post-Vax (-1%) periods. Over 70% of STU transitioned to HSAT, and its usage surged five months after the vaccine introduction. Conclusion Sleep testing services utilization recovered differentially during the pandemic (PSG vs HSAT), including a surge in HSAT utilization post-vaccination. Support (if any) Supported by National Institutes of Health, National Heart, Lung, and Blood Institute (NHLBI) K25 funding (1K25HL152006-01 [J.R.]); ZOLL Respicardia (31002 [A.S.]); Airborne Hazards and Burn Pits Center of Excellence (AHBPCE, Award #: FY2024-002 [J.R.]); and the use of facilities and resources at the Center for Innovations in Quality, Effectiveness, and Safety (CIN 13-413), Michael E. DeBakey VA Medical Center, Houston, TX. The opinions expressed are those of the authors and not necessarily those of the Department of Veterans Affairs, the U.S. government, or Baylor College of Medicine.