Sleep techs, therapists seek middle ground

YARMOUTH, Maine - Sleep medicine professionals recently extended an olive branch to respiratory therapists who may feel as though sleep techs are infringing on their turf.

The American Academy of Sleep Medicine (AASM) and the American Association of Sleep Technologists (AAST) issued a joint open letter to various state respiratory society presidents seeking to assure RTs that they are not trying to "restrict the practice of respiratory care."

The May 13 letter states, in part: "Our goal with this communication is to end the miscommunications surrounding the issue of certification and scope of practice for the respiratory therapist and sleep technologist professions. We look to participate in a reasonable and productive dialogue."

The letter is in response to a message sent in April by the American Association for Respiratory Care (AARC), which claimed that respiratory therapy was under attack by various polysomnography laws.

At issue: Respiratory therapists could be forced by law to obtain additional credentials to provide CPAP therapy.

Laws differ by state and several states have recently grappled with trying to legislate who can do what, said Bob McCoy, homecare section chair for the American Association for Respiratory Care.

"CPAP has been the scope of respiratory therapy practice forever," he said. "They now have to compete with the side specialty for PSGTs."

Many providers report mixed feelings on the issue. They would like to maintain the integrity of RTs, which takes a minimum of two years of education, compared to several weeks of training to become a sleep tech.

"As an RT, I am concerned about the quality of care related to CPAP and how it affects the cardiopulmonary system," said Eric Parkhill, vice president of Home Medical Professionals in Atlanta. "You are not just treating the airway but the lungs."

Ultimately, everyone just wants a level playing field, providers say.

"If you have to be a therapist to set up patients in the home why not require that a therapist to do it in a sleep lab," said Jeff Knight, CEO of Premier Homecare in Louisville, Ky., and a member of the Kentucky Respiratory Care Board. "But as a businessman, I say, 'If you are going to let labs use sleep techs (to set up CPAP), let me use them, too. They don't cost as much.'"