OD4 Pediatric sleep medicine during the COVID-19 pandemic and beyond

Summary

The unprecedented challenges in sleep medicine stemming from the current COVID-19 pandemic are arguably even more complicated with regards to pediatric sleep patients. While some general guidelines have been put forward for adult sleep labs, including recommendations for phased re-opening, many of these recommendations are not pertinent to the pediatric population or would be very difficult to implement in pediatric sleep centers, especially in centers that serve medically complex patients as well as otherwise healthy children.

Anecdotal evidence suggests that while safety precautions in the sleep lab regarding screening of pediatric patients and recommendations regarding  provision of personal protective equipment (PPE)  for sleep technology staff and cleaning of non-disposable equipment seem relatively straightforward, there is much less consensus among the major pediatric sleep centers in terms of such critical issues as pre-sleep study, viral testing of patients, screening of caregivers accompanying patients in the lab, triaging of patients for sleep studies, phase-based exclusion criteria, staffing ratios, social distancing and mask use requirements, guidelines for positive airway pressure titrations and those involving patients on ventilators and criteria for gradual expansion of testing beds in a phased approach. 

Adaptations in the delivery of clinical services, including behavioral sleep medicine, may vary according to many factors, including the nature of the presenting complaint (eg, sleep disordered breathing, hypersomnia, parasomnia, insomnia, circadian rhythm disruption) and additional considerations such as insurance coverage and billing for telemedicine visits. In academic institutions, issues regarding standards for training sleep fellows, as well as availability of adequate opportunities for teaching medical students, residents, and other specialty fellows.

Many of these issues are likely to persist or recur as the pandemic waxes and wanes and fluctuates depending upon the region and country for many months to come. It is expected that some of the adaptations in delivery of care for pediatric sleep patients during COVID-19 may result in permanent changes in clinical practice that have the potential to improve delivery and quality of care. This symposium, while essentially representing the experience of a number of prominent clinical leaders in pediatric sleep medicine in the US, will address issues that are common to the practice of sleep medicine in children globally in order to initiate an international dialogue  and begin to generate solutions for and innovative approaches to challenges in delivering quality care for children and families across the world.

Learning Objectives

Upon completion of this CME activity, participants should be able to:

• Recognize the unique challenges in delivering care for pediatric sleep patients
• Assess the opportunities, benefits, challenges, and limitation of telemedicine in pediatric sleep medicine
• Examine the impact of pandemic on sleep in children and teenagers and its impact on overall learning, stress, and behavioral problems
• Recognize the unique risk of doing pediatric sleep studies and be able to develop and implement a strategy to restart and operate sleep laboratory during and beyond the pandemic
• Identify the challenges faced for training sleep fellows and unique opportunity to use teleconferences and tele-symposiums to fill in the learning gap

Target Audience

Clinicians, nurses, nurse practitioners, trainees and technologists who evaluate and treat children with sleep disordered breathing and involved in ordering and performing sleep studies, and or involved in training fellows

Chair

Umakanth Katwa (United States)

Pediatric sleep medicine and COVID pandemic: Identifying the issues and survey results 

Bobbi Jo Hopkins (United States)

Impact of COVID on sleep in children: Are we staring at another pandemic?

Judith Owens (United States)

Telemedicine in pediatric sleep medicine: Adapt, expand, and innovate

Stephen Sheldon (United States)

Operating pediatric sleep lab during and beyond the pandemic: Challenges and opportunities

Umakanth Katwa (United States)

Learning and teaching during pandemic: Dawn of a new era!

Maida Chen (United States)