睡眠学会呼吁首次就诊时筛查呼吸暂停

明尼阿波利斯——美国睡眠医学会（AASM）在联合专业睡眠学会（APSS）年会上呼吁，利用患者首次进行Medicare预防保健就诊的机会对其进行简单的睡眠呼吸暂停问卷筛查。

AASM主席、罗切斯特梅奥医院内科学教授Timothy Morgenthaler医生指出，这样做将有助于在患者首次参加Medicare计划之时识别出阻塞性睡眠呼吸暂停（OSA），从而增加诊断和治疗该病的机会，并且还可能降低患者发生相关慢性疾病的风险，从而控制医保支出。


Timothy Morgenthaler医生

据估计，目前有20%的Medicare受益人患有OSA。随着肥胖率的上升，这一比例仍在增加。如果不进行治疗，OSA可增加高血压、心脏病、2型糖尿病和卒中的风险。

AASM一直在游说国会将一种经过验证的OSA筛查方法纳入Medicare初次就诊中。Morgenthaler医生指出：“将这一重要措施纳入法规将能够消除不利于新的Medicare受益人获得睡眠呼吸暂停相关服务的障碍。”

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By: ALICIA AULT, Cardiology News Digital Network

MINNEAPOLIS – The American Academy of Sleep Medicine is pushing to have a simple sleep apnea questionnaire included in the initial Welcome to Medicare preventive care visit.

Including such a screening tool would help identify obstructive sleep apnea (OSA) when patients first join the Medicare program and thus improve the odds of diagnosing and treating the condition, said Dr. Timothy Morgenthaler, president of the AASM. Getting a handle on OSA could also reduce the potential that the beneficiary will develop related chronic conditions, and that will help Medicare curb expenditures, he said.
 
An estimated 20% of current Medicare beneficiaries have OSA. That number is expected to grow with the rising obesity rates, he said. Untreated OSA can increase the risk of hypertension, heart disease, type 2 diabetes, and stroke, said Dr. Morgenthaler, who is professor of medicine at the Mayo Clinic in Rochester, Minn.

The AASM has been lobbying Congress to include a validated OSA screen in the initial Medicare visit and found sponsors in Rep. Michael Burgess (R-Tex.) and Rep. Bobby Rush (D-Ill.). The two congressmen introduced a bill (H.R. 4695) that would do just that on May 21.

"This important legislation addresses the barriers that prevent new Medicare beneficiaries from receiving what we know to be required sleep apnea services," Dr. Morgenthaler said at the annual meeting of the Associated Professional Sleep Societies.

Rep. Erik Paulsen (R-Minn.), who recently signed on to the bill as a cosponsor, told AASM attendees that adding an OSA screen to the initial Medicare visit would help increase detection of disease, raise patient awareness, and "improve health care quality and reduce costs to the Medicare program," over the long term.

The AASM is asking its members to back the legislation and educate local lawmakers and patients through the group’s Seniors Sleep Campaign.

The association also wants to make it easier for board-certified sleep medicine specialists to care for Medicare patients from start to finish. Currently, antikickback laws prevent sleep specialists and sleep centers from directly providing therapeutic durable medical equipment to Medicare patients, said Dr. Morgenthaler.

The AASM has developed model language for an exception to that statute, which it hopes legislators or regulators will approve, he said. It would allow board-certified specialists to provide the continuum of care from start to finish, including durable medical equipment such as continuous positive airway pressure devices.

Eliminating the current fragmented system of care would eliminate waste, simplify the work flow, and improve the quality of care and reduce costs, said Dr. Morgenthaler.