AASM: Data, details please

Friday, February 29, 2008

Industry watchers expect to see CMS approve home-based sleep tests later this month, but the American Academy of Sleep Medicine (AASM) has raised some concerns with the proposal.
While the academy supports home sleep tests, its support has limitations, said Dr. Alejandro Chediak, president of AASM.
In particular, the academy questioned whether data culled from various sleep studies to support the proposal truly reflects the Medicare population.
"The average age of the individuals who were tested is 52, which is not quite beneficiary age," he said. "As you get older, you develop more problems, with more complexities. Also, age and comorbidities were excluded and that doesn't translate well to the Medicare population."
Chediak would also like to see clear guidelines on who is qualified to perform sleep tests and in what cases a sleep test is appropriate. Without those defined controls, he fears a "free-for-all" of home testing and sleep apnea diagnoses while more severe problems are overlooked.
"Our concern is that if patients are over-treated for apnea and under-diagnosed for other conditions, some may not meet the benchmark for successful CPAP treatment," said Chediak. "We have to make sure patients are properly treated. A number of those that will be diagnosed with some degree of apnea may have another problem altogether."
Without guidelines for successful treatment, CPAP therapy could be inappropriately withdrawn from patients not meeting treatment benchmarks, he said.
AASM believes all sleep testing should be done under the oversight of a sleep medicine specialist and through accredited sleep centers.
"Your CPAP use is better and satisfaction with the therapy is improved if you are being treated by a certified sleep doctor," said Chediak.