October 2008

AARC Congress is the Place to be for Sleep
Sleep professionals will have plenty to choose from at this year’s AARC Congress, coming up December 13–16 in Anaheim, CA. Here are just a few of the topics devoted especially to our area of expertise—

• What Every Respiratory Therapist Should Know About Polysomnography
• Examinations of Relationship Functioning and the Effect of Co-Sleeping Arrangement on Objective Sleep
• The Use of Positive Airway Pressure in Sleep Disordered Breathing

Check out the ADVANCE PROGRAM to learn more about the meeting, and if you plan to attend, don’t forget to make time for our section business meeting, 11:35 a.m.–12:15 p.m., Tuesday, December 16.

PAP Therapy LCDs Revised
Revised Local Coverage Determinations (LCDs) for PAP devices have now been issued by the Durable Medical Equipment Medicare Administrative Contractors. The new LCDs include, among other things, a loosening of the restriction on the channel set previously described for a type IV device, a requirement for beneficiary education by the entity conducting the home sleep test (but allowing prerecorded instruction rather than face-to-face education), expanded dates for reevaluation of patients to ensure the benefit from PAP therapy, and a requirement that patients failing an initial 12 week trial be requalified. READ ARTICLE

An Easy Switch?
Researchers from the University of Virginia have discovered a switching mechanism in the eye that may one day lead to a way to reverse normal sleep/wake patterns. Specifically, investigators found light receptors in the eye play a key role in setting the suprachiasmatic nuclei, the brain’s main timekeeper. “The significance of this research for humans is that it could ultimately lead to new treatments for sleep disorders, perhaps even eye drops that would target neural pathways to the brain’s central timekeeper,” study author Susan Doyle was quoted as saying. The study was published in a recent issue of the Proceedings of the National Academy of Sciences. READ ARTICLE

OSA-related Costs Skyrocketing
A recent article in USA Today turned the national spotlight on obstructive sleep apnea (OSA), sleep testing, and CPAP therapy. According to the report, Medicare spending on CPAP for OSA ballooned from $291 million in 2004 to $571 million in 2007, and spending is expected to increase further with the approval of home sleep testing. In some areas, Medicare spending for CPAP has gone up more than 100% since 2004 (Lady Lake, FL, for example, saw a rise of 324%), and the number of sleep testing centers has skyrocketed as well, from 857 in 2004 to 1475 in 2007. Nationwide, bed capacity has risen by 13% this year and is expected to jump another 17% next year. The article quotes several sleep experts, who note much of this growth is being fueled by a greater recognition of sleep problems, easier access to testing, an aging population, and the growing number of Americans who are overweight or obese. READ ARTICLE

Bariatric Surgery No Panacea for OSA
Patients probably shouldn’t look to bariatric surgery as a cure for their OSA, report researchers from Walter Reed Army Medical Center who followed 24 patients for a year following the surgery. While patients did reduce their body mass index from an average of 51 prior to the operation to an average of 32 a year later, and postoperative polysomnography showed an initial reduction in the apnea-hypopnea index in 22 of the patients, a year later, 23 of the 24 still had persistent OSA. The authors conclude the severity of the OSA is more important in determining resolution of the condition than the patient’s weight. The investigators published their findings in a recent issue of the Journal of Clinical Sleep Medicine. READ ARTICLE