Monday, January 12, 2009

Accreditation and Reimbursement

A reader asks, via email:
Is Somnus Sleep Clinic accredited by JCAHO and AASM? How do these processes work? Must one occur before the other? Is accreditation required for reimbursment?

Somnus Sleep Clinic is accredited by The American Academy of Sleep Medicine (AASM). In Mississippi and many other states, AASM accreditation is necessary for a sleep center/lab to receive reimbursement for a sleep study from Blue Cross/Blue Shield plans. In some states, other insurance companies also have this restriction.

I don't know too much about JCAHO accreditation of sleep labs/centers. I believe that in some states (not MS), some insurance companies will reimburse for sleep studies at labs/centers accredited by either the AASM or JCAHO. I believe that JCAHO accreditation is mainly for hospital-based sleep labs/centers.

If any reader has more info about JCAHO accreditation for sleep labs/centers, please leave a comment

Friday, January 02, 2009

Sleep and coronary artery calcification

Several medical bloggers have posted about a recent study in which increased sleep time was associated with a decreased incidence of coronary artery disease (as measured by coronary artery calcification).

The problem with these observational studies looking at sleep duration and mortality/morbidity is that they don't distinguish between 1) voluntary sleep deprivation, 2) primary insomnia, and 3) insomnia secondary to medical/sleep disorders.

How is a doctor to use the data from this study???
I doubt writing a prescription for a sleeping pill would improve someone's coronary artery calcification score. However, advising someone with voluntary sleep deprivation (due to work pressures, etc) to extend their sleep hours might (if they take your advice)- I base this conclusion on prior studies which demonstrated that voluntary sleep restriction does lead to adverse metabolic consequences. And of course, treating any obstructive sleep apnea present is important, especially in patients with pre-existing coronary artery disease, atrial fibrillation, or congestive heart failure.