Approximately 4 – 8% of the adult population of the United States is currently suffering from obstructive sleep apnea. Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. You may have sleep apnea if you snore loudly and you feel tired even after a full night’s sleep.
There are two types of sleep apnea.
Obstructive sleep apnea, the more common form, occurs when throat muscles relax.
Central sleep apnea occurs when your brain doesn’t send proper signals to the muscles that control breathing.
Obstructive sleep apnea can lead to life-threatening conditions such as high blood pressure, cardiovascular disease, strokes and an increased risk of heart attack. In fact, a 2010 report from McKinsey & Company in conjunction with the Sleep Medicine Division of Harvard Medical School indicates that sleep apnea was the 4thmost expensive disease in the United States behind cardiovascular disease, cancer, and diabetes. Diagnosis and treatment of this condition is imperative to minimize the future impact of these and other complications.
Historically, sleep testing to diagnose obstructive sleep apnea has been conducted almost exclusively in a facility setting where the patient is monitored throughout the night by a sleep technologist. However, this testing has its drawbacks including the inconvenience of having to spend a night or two away from your home (where you’re most likely to achieve a good night’s sleep), higher healthcare costs to the patient and health insurance system and potentially extended wait time to diagnosis based on sleep center availability.
Based on significant advancements in technology, home sleep testing (HST) has emerged as an alternative approach for diagnosis of obstructive sleep apnea. Performance of a HST entails the use of a small diagnostic device consisting of a few sensors which patients can easily apply to themselves. These devices can be obtained from a Sleep Specialist’s office or mailed to the patient’s home. This approach allows patients to sleep in the comfort of their own home and undergo testing at a cost of about $350 vs. a sleep center test that may cost as much as $3,000. HSTs are now supported by the American Academy of Sleep Medicine (AASM) and the Centers for Medicare and Medicaid Services (CMS) as a safe, effective alternative to attended sleep studies.
When is an attended sleep test the right choice? Attended sleep tests are clinically appropriate for diagnosing sleep disorders other than obstructive sleep apnea and for diagnosing obstructive sleep apnea in patients with co-morbid conditions or complications. CareCore National’s Sleep Management Criteria offers comprehensive guidelines to assist in ensuring that patients receive the most appropriate care in the right setting. Since 2009, CareCore National’s Sleep Management program has provided guidelines to physicians, resulting in 50% to 60% of patients receiving a home sleep study for the purpose of diagnosing obstructive sleep apnea. The benefits of convenience and cost savings for patients parallel the advantage for the health insurance payor: an efficient diagnosis of a disease that when treated will improve the member’s quality of life and reduce the risk of further complications.
McKinsey & Company report, “The Price of Fatigue: The surprising economic costs of unmanaged sleep apnea.” December 2010. Produced in conjunction with the Harvard Medical School Division of Sleep Medicine.