Surgery is scary business for most patients, but patients with undiagnosed sleep apnea have something extra to worry about. Anesthesia and post-operative pain medications in conjunction with sleep apnea could cause fatal complications. Because of this danger and the growing prevalence of sleep apnea, diagnosing patients prior to surgery is of the utmost importance. Respiratory providers can play a vital role in educating anesthesiologists about the dangers of undiagnosed sleep apnea. Integration of a sleep apnea management program could reduce the risk of an adverse event during a sedated surgery or procedure experience. In the following article, Kathryn Hansen discusses the merits of such a plan and what respiratory therapists need to know about patients at risk.
The following studies show a link between sleep and fibromyalgia.
The link between fibromyalgia and sleep dates back to a 1975 study by Dr. Harvey Moldofsky, who found a high incidence of alpha-delta sleep in fibromyalgia patients — or the intrusion of alpha waves (arousal pattern) into restorative sleep. Only recently have researchers begun to explore the role of sleep apnea in fibromyalgia.
At a March 20 news conference, Centers for Medicare & Medicaid Services (CMS) Acting Administrator Kerry Weems announced that the agency had sent letters via overnight mail to suppliers who submitted bids to participate in the first round of competitive bidding. The letters arrived March 21.
As expected, on March 13, 2008, the Centers for Medicare & Medicaid Services (CMS) released a decision memo on a national coverage determination (NCD) for the use of home sleep tests to diagnose obstructive sleep apnea (OSA). CMS’ decision had been the subject of much speculation in the clinical and provider communities, and many expected CMS to approve home sleep studies for diagnosing OSA. In fact, CMS’ decision permits the use of home sleep tests, but CPAP is covered only for a trial period of up to 12 weeks regardless of the type of test performed, unless the beneficiary demonstrates that he is benefiting from therapy. The devices approved for home studies include Type II, III or IV with at least three channels.
On March 14, the much-anticipated decision memo on a revised National Coverage Determination (NCD) for CPAP coverage for obstructive sleep apnea arrived from the Centers for Medicare & Medicaid Services (CMS). Unfortunately, with it came the same questions that have been posed by many in the industry for several months. These questions relate to a clear definition of beneficiary improvement; the role the HME can take in home sleep testing; how titration is to be accomplished; and reimbursement.