When to Split a Sleep Study
This is one of the biggest debates among sleep techs. Should split night studies be performed and when should they be performed? There are those who believe that you should never do a split night study. There are those, usually with a financial stake, who believe that you should always do a split study. Different labs have different policies on the subject.
The benefit to a split night study usually is solely for that of the patient and the payer. You have one test that diagnoses and treats the patient. We now have technology that can monitor the patient after the test if the study was not complete and adjust the pressure based on the download. It gives you a good base to start using therapy right away. You have less chance of the patient not receiving therapy and you can start them at home much faster. Insurance companies like it because they are just paying for one test.
The drawbacks are seen with compliance and with how well the titration was completed. You go into the room at 1-2 a.m. and you put a mask on a patient and tell them to go back to sleep. You have half the night to make them comfortable with the mask and to find a final pressure for the patient. The drawback is that 1 a.m. is not an optimal time to introduce new therapy. It limits how many REM cycles you have. It also limits dealing with issues with mask fit or anxiety.
There are times where a split study is ideal. If the patient has severe sleep apnea it is better to get them titrated sooner rather than later. You can also bring them back after they have gotten used to the therapy to complete the titration. If a patient is requalifying for PAP then a split allows it to be done easier. You already know they have sleep apnea, you are just redemonstrating it to the insurance company. It saves the patient a copay and gets them their new equipment sooner.
I do not believe there is a right side or a wrong side to this argument. I think that like all sleep studies it is a very individual decision based on the patient's needs. If a patient is high anxiety or claustrophobic, a split would not be ideal for them. If the patient has severe sleep apnea then doing a split study will allow them to have equipment sooner. As long as you make the interest of the patient your priority, you can not make a wrong decision.