Peer-reviewed article

711 Changes in Healthcare Visits and Sleep Medication Use in Sleep Medicine Patients during the COVID-19 Pandemic

Debian A, Arentson-Lantz E, Kokanda M, Shaib F, Nowakowski S · 1 May 2021

Abstract

Abstract Introduction Patients may be experiencing increased stress and sleep disturbance due to healthcare changes during the COVID-19 pandemic. Healthcare changes may include telemedicine visits, delayed or canceled appointments and sleep studies. The purpose of this study was to assess the association between changes in healthcare and sleep medication use on sleep disturbance and insomnia severity. Methods Between June-November 2020, 81 sleep medicine clinic patients (54.8 ± 15.9 y, 44% male, 69% Caucasian) completed an online survey that included questions about COVID-19 (tested for coronavirus, test results, willingness to be vaccinated for COVID-19, changes in health care visits and sleep medications during the pandemic), PROMIS measures (Sleep Disturbance, Sleep-Related Impairments), and Insomnia Severity Index (ISI). Stepwise linear regression was performed using SAS to determine if changes in healthcare and sleep medications predicted poorer sleep. Results Among participants, 32% were tested for coronavirus, out of those 8% tested positive for COVID-19. 74% were willing to get vaccinated and 65% were willing to get their children vaccinated. 35% changed their healthcare office appointments to telephone visits, 54% changed to video visits; whereas 26% cancelled and 32% rescheduled their healthcare appointments. Changes in health care visits during the pandemic had a significant increase on ISI score (3.98 ± 1.66, p=0.019). Changes in sleep medication during the pandemic had significant effect on Sleep Disturbance (7.15 ± 2.51, p=0.005), Sleep-Related Impairments (8.69 ± 2.68, p=0.001) and ISI (6.04 ± 1.66, p=0.001) measures. Conclusion Sleep medicine patients who reported changes in sleep medication reported higher insomnia severity, sleep disturbance, and sleep-related impairments. Patients who reported changes in healthcare visits during the pandemic reported higher insomnia severity. Assessing sleep medication changes and preference for healthcare visit format is advised when treating sleep medicine patients during the pandemic. Support (if any) This work is supported by National Institutes of Health (NIH) Grant # R01NR018342 (PI: Nowakowski) and by the Department of Veteran Affairs, Veterans Health Administration, Office of Research and Development, and the Center for Innovations in Quality, Effectiveness and Safety (CIN 13–413).