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Adventures in Sleep

Sleep Study 101

Published May 29, 2014 9:59 AM by Penny Mehaffey

There's a conversation going on in LinkedIn revolving around this question: Does a sleep study require a doctor's order? It's been an interesting feed to follow. You would think that this is a no-brainer, right?  It's a medical test, so it requires a physician's order.

But what's curious to me is why so many people even ask this question. I mean, they don't ask if they need an order for an x-ray  or a lab test, so what's going on here? Is it a lack of understanding about what a sleep study is, fueled by all the media information available? Is it a lack of respect for the discipline of sleep medicine and thinking that "it's just a sleep study, I don't need an order for that"?

Or is it just a simple question. I take several calls a week for this question. My feeling is that people in general have several motivations. I think the biggest is financial. Let's face it, copays aren't what they used to be and if you add up all the required visits that are now associated with having a sleep study, it could be a car payment. 

And that's only for diagnostics; we won't even talk about CPAP. I think the requirements we have to adhere to seem more like barriers to care for the patients. This was my comment to the feed.  All the new requirements imposed on us by all the insurers make us look like part of the problem. I want to be an advocate for my sleep patients, not an obstacle to overcome. 

I confess I feel very frustrated by the current environment in which we must operate and I don't trust insurers to have the best interest of my patients at heart, yet my hands are tied.

What to do?


Sleep labs are doing this as well. The home sleep studies I have seen still require a doctor's order and are done through an independent testing facility (funny I could've sworn called IDTF). Home sleep studies are significantly cheaper. This gives the patients who can't afford their copays; which is a good deal of people, an affordable option. I'm not saying I am all for it, and maybe I am being naive,  but I think there is more to this story here.

Aimee , Homecare - RRT/RCP September 7, 2014 3:27 AM
Clyde NC

Not surprising....RESMED corporate strategey is to control the sleep market by pushing Home Sleep Testing to areas that do not have  expertise in sleep so they can control the message. Their Facebook page last week referenced all the advantages of using HST over an in lab study.....if your lab is supporting RESMED cpap and masks you are killing your own job.

Concerned About Sleep

Concerned About Sleep June 17, 2014 10:27 AM

Just recently heard that ResMed has partnered with Humana in KY to cut sleep labs out of all sleep testing.  ResMed is offering DME co the ability to perform HST tests without an OIG license or an RPSGT on staff and No MD order.  Humana refers the pt to particular DME co that have been chosen by ResMed then the HST is performed by the DME and then the pt is setup on a ResMed Auto.  If this is correct then I can't wait to see the first lawsuit.  When will insurance companies and these manufactures learn that you get what you pay for.  

t, sleep - owner/operator, IDTF June 11, 2014 8:37 AM
Central KY

I agree 100%. Being a therapist in homecare setting patients up on Cpap and Bipap everyday. I don't believe insurance companies are thinking about the patients at all.  

With the passing of Obamacare several new options have come available for people here in Utah. Which is great you would think. However they do not cover anything with the diagnosis of obstructive sleep apnea.  

Sleep studies do require a doctors order but may not even be covered.

Darren Douglas, Sleep - Respiratory Therapist, Petersen Medical June 10, 2014 8:20 PM
Orem UT

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    Adventures in Sleep
    Occupation: Sleep technicians
    Setting: Various sleep facilities
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