Categorized | Sleep Apnea

News with the American Academy of Sleep Medicine AASM and Home Sleep Testing


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There is some good news to report finally out of the AASM.  The American Academy of Sleep Medicine is finally after many years of being against the practice, moving to adopt home sleep apnea testing as an approved and promoted form of diagnosing OSA.  This is very significant because for so very long they were not backing this form of testing, even though so many insurance companies were completely for it.  This article is going to try to uncover some of the reasons for why the AASM was so horribly slow in getting up to date with new technology and what types of factors might be influencing their strange decision making with regards to sleep medicine.

Let’s first start out with the most well known person in the world and the founder of the AASM, Dr. William Dement from Stanford University. Dr. Dement invented the overnight Polysomnograpy Testing which for so many years since its inception has been considered the “Gold Standard” for testing for sleep apnea.  He also discovered REM sleep many decades ago, and he also teaches the most popular class in the history of Stanford University called “Sleep And Dreams”.  What is remarkable also is that Dr. William Dement began approving and support home sleep testing over 10 years ago because he was very impressed with the technology and the accuracy of the results.  So why did the AASM, the organization that Dr. Dement founded take so very long to get to the point where it is right now?  In my opinion, the answer is simple, it all has to do with money and greed, not anything at all with good sleep medicine.

So lets examine it further.  What is the AASM?  The AASM is a group of doctors who are known as “Sleep Doctors”.  If a physician has the AASM symbols on their business card or their white coat, it means they are board certified in sleep medicine.  Also, to be part of this “Academy” you also pay fees which are used for all types of things including new multi-million dollar buildings in Illinois for the administrative offices of the AASM… and also for “other things”.  Anyways, by and large, the overwhelming majority of AASM accredited doctors are Sleep Doctors who own local sleep labs.  These sleep labs make the bulk of their money by completing overnight PSG in lab sleep studies on patients who are suspected of having sleep apnea.  Hopefully by this point, the article here is starting to uncover what is really going on.

So lets assume that a board certified sleep doctor owns a sleep lab.  And lets assume that they are being re-imbursed by insurance companies or Medicare when they complete an “in-lab” sleep study with about $1500 per patient.  Let’s also assume that over 70% of their revenue comes from these types of tests.

Then, lets start thinking about the alternative to in-lab sleep testing.  The HOME SLEEP STUDY, which the AASM has failed to recognize for so many years as legitimate.  Anyways, this type of sleep study only brings in $200-300 on average per study.  That is less than 25% of the revenue.  So here is the point, sleep doctors would much rather continue to perform in lab sleep studies compared to home sleep tests because they earn so much more money on them.  The rationale that the home sleep studies are not as valid is completely not true, and in-fact, it is often the exact opposite.

When you consider the healthcare system our country has, just realize that there are way too many reasons why the current system is not sustainable.  The way that sleep doctors and the AASM have handled sleep medicine proves that there are way too many special interests involved to be giving the taxpayers and the patients a fair shot at good, affordable, and best practice medicine.  It is a good step for the AASM to be moving in this direction, but there is much suspicion that they will have some more tricks up their sleeves to support their constituents(sleep doctors) so be aware.

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