March 2008

Don’t Forget to Share Your Sleep Week Activities!
Hopefully, many of you got out into your communities to celebrate National Sleep Awareness Week earlier this month. If you did, please remember to share your activities and photos with the section. E-mail a brief summary, along with a photo or two, to Section Chair Karen Allen. We’ll feature the submissions in an upcoming issue of our Quarterly Bulletin.

Problems Seen with New AASM Scoring Manual
Certain provisions in the new Scoring Manual published by the American Academy of Sleep Medicine are being called into question by industry leaders. According to a recent article in Sleep Review, the manual is based on literature reviews and consensus reports from several task forces, but the members of those task forces were not asked to review the manual prior to publication. The authors highlight numerous problems areas, including those dealing with the addition of frontal leads for the scoring of slow wave sleep, bipolar EEG discrepancy, alternative electrooculogram recordings, movement event scoring, scoring of bruxism, scoring of REM sleep behavior disorder, technical recommendations for respiratory event scoring, apnea and hypopnea scoring, and scoring of Cheyne-Stokes respiration. Compliance with the manual will be mandatory for accredited centers in July of this year. READ ARTICLE

Trouble for Physician-Owned Sleep Centers in Florida
Physician-owned sleep centers in Florida must have a physician onsite while sleep studies are being performed. That’s the take home message from a state response to a petition made by a physician group, asking whether rules governing direct supervision for physician-owned services applied to sleep tests. According to the state, “The Board recognizes that under the current Medicare guidelines, physicians are only required to provide ‘general’ supervision of sleep studies, which means the physician is not required to be physically present during the testing. However, in order to benefit from the exception set forth in Section 458.053(o)3f, Florida Statutes, the services must be provided under the ‘direct supervision’ of the referring health care provider . . .  the board [is] of the opinion that because the services to be provided at the Petitioner’s Sleep Center will not be provided under the direct supervision of [the Petitioner], Petitioner’s proposed referral of patients to its Sleep Center is precluded by Section 458.053(5), Florida Statues.” READ STATE RESPONSE (click on “§456.053, F.S.”)

Perioral Burns During Adenotonsillectomy
Adenotonsillectomy is a common procedure for children with sleep disordered breathing and is generally considered to carry few risks. A new study out of the University of Utah School of Medicine, however, suggests perioral burns are more common than believed among kids who undergo the surgery. They reviewed all cases of children under age 18 who developed perioral burns during an adenotonsillectomy or tonsillectomy at one hospital over an 8 year period, and also conducted an online survey of pediatric otolaryngologists. Seven burn cases were identified in the case review, and 60.4% of the survey respondents reported having a patient develop a perioral burn at some point in their careers. Burns were most commonly caused by a defective electrocautery device tip, followed by operator error. READ ARTICLE

Orientation Session Improves Mask Acceptance Rates
An orientation session led by a polysomnography technician on the night of positive airway pressure titration (PAP) improves objective sleep quality and acceptance of the nasal mask, report Brazilian researchers publishing in this month’s Sleep & Breathing. They compared 782 patients who underwent the orientation with 699 patients who did not, finding significantly fewer patients in the orientation group ended up refusing the face mask (44 vs. 80). “Such an addition to PAP titration could be an efficient intervention to improve PAP compliance,” write the authors. READ ABSTRACT