Market for Sleep Labs Will Shrink

[leejgbt]

Muffy is correct it is not RLS. When I wrote this I was going by a training i sat in on that dealt specifically with the issues I listed. Also, I was not talking about how to diagnose the other morbidities but how they can mess up a homme sleep test. But, after talking to the RTs in the sleep lab they say the most common issue with home sleep tests is PLM and any other problems with the "leads" coming off. This gives me more hope that home sleep tests will become more prevelent as these issues can be overcome.

Most of the sleep techs I polled said they were for home sleep testing as the first line of diagnostics.

[roster]

Just how many of these things would be obstacles to home testing, IYO?

What I understand so far is that, of all the comorbidities, only PLMS needs an in-lab PSG for a definitive diagnosis.

I wonder if the portable home sleep monitoring systems can be augmented to detect PLMS?

[roster]

People will begin to catch on very quickly:

......... These programs offer the ability to test drivers for sleep apnea using out-patient testing via ambulatory tests wherever the driver is sleeping that night. Ambulatory testing is less costly and more convenient for truck drivers, making it easier for them to get tested sooner and start receiving treatment. .........

This would also be true:

...... Ambulatory testing is less costly and more convenient for most people, making it easier for them to get tested sooner and start receiving treatment. .......

Here is the entire news story from which the first quote was extracted:

Million Mile Commercial Truck Driver Says Sleep Apnea Program Saved His Life

Written by: David Castillo on November 10th, 2009

SleepSafe Drivers, Inc., a national provider of sleep apnea diagnosis and treatment programs for fleets, today announced positive preliminary results from a clinical trial focused on testing and treating truck drivers suffering with
sleep apnea as part of a national contract with J.B. Hunt Transport Services, Inc. The clinical trial is a collaborative effort between J.B. Hunt, SleepSafe Drivers, Inc., and Fusion Sleep LLC, Georgia`s leading provider of clinical
sleep medicine services to patients and employers.

The goal of the trial, which is backed by an Independent Review Board, is to improve the health and safety of the drivers. The trial results will document any cost savings from reduced medical expenses and lower accidents as a
consequence of the program. J.B. Hunt is accelerating the pace of the trial and expects to continue expanding the program over time.

“We are committed to enhancing the safety and health of our drivers, and SleepSafe Drivers is helping us get that done,” said Greer Woodruff, Senior Vice President of Corporate Safety and Security at J.B. Hunt. “One of our Million
Mile drivers recently told us that he felt the sleep apnea program had literally saved his life. After starting APAP therapy, that driver has lost 115 pounds, knocked out his challenging and chronic daytime fatigue, and was able to begin exercising again for the first time in years. There is absolutely no doubt that he is healthier and safer as a result of the program.”

One of the major benefits of the SleepSafe Drivers program is the Company`s unique On-SiteTM testing and Sure ComplianceTM treatment program designed specifically for truckers. These programs offer the ability to test drivers for sleep apnea using out-patient testing via ambulatory tests wherever the driver is sleeping that night. Ambulatory testing is less costly and more convenient for truck drivers, making it easier for them to get tested sooner and start
receiving treatment.

“We are proud to be helping J.B. Hunt deliver on their goal of improving the health of their drivers while also reducing avoidable risk and expenses,” stated Dana Voien, president of SleepSafe Drivers. “Working with our clinical partners
at Fusion Sleep in Atlanta, we are confident that fleets will recognize a four to ten month payback period on the program investment, so it more than pays for itself in the first year alone. Our national network assures that we can cover a fleet`s entire needs across the nation.”

“The goal of the trial is to quantify the health benefits and document changes in fatigue-related accidents and safety as a consequence of this unique program. Preliminary findings already demonstrate real and significant health benefits,
and we anticipate that this research will provide us with the most comprehensive data and cost-effective model for disease and accident prevention in the trucking industry,” said Jeffrey Durmer, MD, PhD, and Chief Medical Officer of
Fusion Sleep and principal investigator of the clinical trial.

About SleepSafe Drivers, Inc.

SleepSafe Drivers, Inc. is a provider of programs to reduce sleep apnea risk for both trucking fleets and their drivers. The SleepSafeDrivers program is designed specifically for employees in risk-sensitive jobs or with challenging work
schedules. The specialized program minimizes downtime and delivers a 90%+ success in treatment compliance. The SleepSafe Drivers management team has unparalleled experience and expertise in ambulatory testing, high-compliance treatment products and protocols, and a strong network with the nation`s leading sleep labs, sleep physicians, and Durable Medical Equipment (DME) providers. For more information, visit http://www.sleepsafedrivers.com.


http://www.shiftworkdisorder.com/millio ... 10552.html

[cinco777]

plr66 wrote

I do remember being told to sleep on my back (as noted before...to produce the worst case scenario of the extent your airway will close with gravity).

For my non-CPAP study, I was told the same as plr66: "sleep on your back - its the worse case". I was told sleeping on my back would "ensure that you qualify for insurance coverage". Of course, with all the wires, etc., sleeping on your back is easiest. I did, however, sleep some on my side during my titration study.

Please note that the Sleep Doctor and Sleep Lab/Clinic don't get to charge you and your insurance for a 2nd study (titration) if you don't qualify for treatment with your first non-CPAP study. My overnight studies were two months apart.

[SuperGeeky]

Let's step back a minute: What Home Sleep Study Interface would be so simple that the 'Average' Individual could use it correctly, given most likely they have limited mental capacity? (Oh gosh, they'll have help??!!)

After designing and implementing Medical Software for Techs, I have to remind myself how few people are the least bit technically savvy.

The complexity of postings just in this topic alone reminds me that those who 'sport' this Web Site are exceptional among us who suffer this illness.

For every member of this forum, are probably tens of thousands of OSA sufferers who would struggle to comprehend it's content.

If the Engineer's have designed such a brilliant Home Study Interface, I commend their genius. But, I suspect some mentally challenged Individual will gum up the works, myself included.

[roster]

Let's step back a minute: What Home Sleep Study Interface would be so simple that the 'Average' Individual could use it correctly, given most likely they have limited mental capacity? (Oh gosh, they'll have help??!!)

After designing and implementing Medical Software for Techs, I have to remind myself how few people are the least bit technically savvy.

The complexity of postings just in this topic alone reminds me that those who 'sport' this Web Site are exceptional among us who suffer this illness.

For every member of this forum, are probably tens of thousands of OSA sufferers who would struggle to comprehend it's content.

If the Engineer's have designed such a brilliant Home Study Interface, I commend their genius. But, I suspect some mentally challenged Individual will gum up the works, myself included.

They are not that complicated. The populace can operate DVRs, play Fantasy League football, apply peel-off tatoos - they can use home sleep monitoring equipment with a little training. Sure, some will screw it up, but they would also screw up an in-lab study.

[DeVilbiss Marketing]

Isn't there a devilbiss machine now which does have a built in oximeter?

The IntelliPAP AutoAdjust with the SmartLink Therapy Management System will interface with a Nonin Oximeter and the Nonin NVision Software.

[SuperGeeky]

Well, looking at my crystal ball this is what I envision:

Tier One:

Govt Mandated Home Testing of Airline Pilots, Truckers and those using heavy equipment. Performed on an annual basis and not monitored by a Sleep Tech.

Tier Two:

Patient has no diabetes, heart ailments, mild excessive daytime sleepiness, slightly diminished cognitive ability, memory complaints, morning headaches. Home Study setup is assisted remotely by Sleep Tech. Constant monitoring by Sleep Tech is optional.

Tier Three:

Patient showing all the signs Severe OSA. High blood pressure, obesity, depression, mood swings, EDS, maybe diabetes, diminished cognitive ability, memory loss similar to Dementia. Send the patient to the Sleep Center immediately!! Assess for Sleep Disorder(s) and other health related complications.


This would work for me


SG

[SuperGeeky]

Oh, one more... Those who have been faulted for a Auto Accident Mandatory Home Sleep Study to keep their Driver's license. Big Brother is watching, but it will be quite a while before it happens...

Unless, Lobbyists for P & C Insurers push it.. I think the Govt. is too busy pushing the Insurers


SG

[roster]

Tier Three:

Patient showing all the signs Severe OSA. High blood pressure, obesity, depression, mood swings, EDS, maybe diabetes, diminished cognitive ability, memory loss similar to Dementia. Send the patient to the Sleep Center immediately!! Assess for Sleep Disorder(s) and other health related complications.

Why not home studies for tier three?

Let their GPs diagnosis the other health problems. In fact, let the GPs issue the portable sleep monitoring equipment.

We don't need specialists to write prescriptions for leaf blower and rubber masks.

[SuperGeeky]

Well Rooster, you have a strong argument!

The only scenario coming to mind is the infamous "Bobo the Dancing Bear" Sleep Study incident. Took two Respiratory Techs a half hour to wrestle Bobo to the ground while he was asleep. It took another two hours to untangle him from all the wiring.

You could just add this to the "Home Sleep Studies Gone Wild Collection", film at Eleven.


Sad Story.....




Really....


SG

[CpapRRT]

http://www.resmed.com/us/products/apnea ... clinicians

Great device. I've actually done a few studies on patient's that did not need them to qualify for a PAP machine, from a healthcare provider standpoint, it's useless, as there is no reimbursment from any insurance company i know of at this time.
And no insurance company I know of will accept the report as a diagnostic sleep study or titration. So, it's either a patient pays out of pocket for the study and can't do anything with it, DMEs/Hospitals use them as screening tools and even then have a difficult time doing much with the report, or insurance companies and wake up and realize how benefical this could be and how truly cost effective it is.

Until they do, you are still stuck with the sleep labs.

[CpapRRT]

And the Stardust....http://stardust.respironics.com/

[SuperGeeky]

Now is that slick or what??!! Stardust, excellent!!

I'd buy stock in Phillips...


SG