Rubins Jeffrey B, Kunisaki Ken M
Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, USA.
Postgrad Med. 2008 Jul;120(2):46-52. doi: 10.3810/pgm.2008.07.1790.
Obstructive sleep apnea (OSA) is a common disease associated with significant morbidity and use of health care resources. Therapy with continuous positive airway pressure (CPAP) devices has low risk and a potentially large benefit in treating this disease. The Centers for Medicare and Medicaid Services (CMS) recently issued a memo revising their earlier position that authorized payment for CPAP only if formal polysomnography (PSG) was performed and was diagnostic for OSA. The revised memo states that CMS will be pay for CPAP therapy for 12 weeks (and subsequently if OSA improves) for adults diagnosed with either PSG or with unattended home sleep monitoring devices. The use of portable home monitoring devices can greatly increase access to diagnosis and treatment of OSA. However, these devices must be used as part of a comprehensive sleep evaluation program that includes access to board-certified sleep specialists, PSG facilities, and therapists experienced in fitting and troubleshooting CPAP devices.
阻塞性睡眠呼吸暂停（OSA）是一种常见疾病，与显著的发病率和医疗资源的使用相关。持续气道正压通气（CPAP）设备治疗这种疾病风险低且潜在益处大。医疗保险和医疗补助服务中心（CMS）最近发布了一份备忘录，修订了其先前的立场，即仅在进行正式的多导睡眠图（PSG）且诊断为OSA时才批准支付CPAP费用。修订后的备忘录指出，CMS将为被诊断患有PSG或使用无人值守家庭睡眠监测设备的成年人支付12周的CPAP治疗费用（如果OSA改善，随后也会支付）。便携式家庭监测设备的使用可以大大增加获得OSA诊断和治疗的机会。然而，这些设备必须作为综合睡眠评估计划的一部分使用，该计划包括能够接触到获得委员会认证的睡眠专家、PSG设施以及在CPAP设备适配和故障排除方面经验丰富的治疗师。
