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Sleep Med. 2003 Jan;4(1):29-33.

Effect of the new Medicare guideline on patient qualification for positive airway pressure therapy.

Author information

  • 1Department of Medicine, VAMC Sleep Disorders and Research Center (III i) and Baylor College of Medicine, 2002 Holcombe Blvd., Room 6C-344, Houston, TX 77030, USA.

Abstract

BACKGROUND:

New Medicare criteria for prescribing continuous positive airway pressure (CPAP) recognize hypopnea as a sleep disordered breathing event. In so doing, hypopnea was redefined as requiring a 4% oxygen desaturation. The criteria omit electroencephalogram (EEG) arousals from the definition. This study was designed to assess how the new Medicare guideline changes CPAP eligibility.

METHODS:

Polysomnograms from 113 consecutive patients with obstructive sleep apnea were scored using both a definition for hypopnea that considered EEG arousals and the new Medicare definition that does not consider EEG arousal. CPAP eligibility was evaluated and compared.

RESULTS:

Sixteen percent of all patients and 41% of patients apnea+hypopnea index </=20 did not qualify for CPAP under the new Medicare guidelines.

CONCLUSIONS:

The new Medicare guidelines may underestimate OSA event occurrence and thereby deny CPAP therapy to many patients.

PMID:
14592357
[PubMed - indexed for MEDLINE]
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