Home sleep test for sleep apnea approved by Medicare

The Centers for Medicare & Medicaid Services (CMS) in the United States have given approval for new sleep test to diagnose obstructive sleep apnea (OSA).

The approval means Medicare beneficiaries will be able to undergo diagnosis for OSA using a sleep test at home.

The new policy is a significant departure from current Medicare coverage as it expands continuous positive airway pressure (CPAP) therapy for Medicare patients.

Obstructive Sleep Apnea (OSA) is a condition in which periods of temporary suspension in breathing (apnea) occur during sleep and it is usually diagnosed by counting the number of sleep disturbances that occur during a specific time interval.

As many as four million Medicare beneficiaries are thought to suffer from some form of OSA.

The CPAP devices provide air pressure through a face mask to help keep breathing passages open during sleep and under current Medicare policy only covers those who have been diagnosed using a specific type of sleep test called polysomnography in a clinical sleep laboratory setting.

The new policy will add coverage for CPAP following a positive at-home sleep test.

In the home tests, the patient wears a device during sleep that collects and records data about airflow and other measurements.

The device is then taken to a doctor who uses the data to determine whether the patient has obstructive sleep apnea or needs further sleep studies or assessment.

As some patients with OSA do not continue with CPAP treatment or do not improve on treatment, the initial coverage is limited to twelve weeks in order to determine whether the CPAP treatment is beneficial.

For those who continue and respond to treatment, long term CPAP is covered.

Experts at the American Academy of Sleep Medicine (AASM) which promotes excellence in sleep medicine health care, education and research, are available to provide official comment on the new CMS policy and its implications for patient care and the sleep medicine field.


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