Sleep Dynamic Therapy

Archive for the ‘PAP Therapy’ Category

Dr. Barry Krakow will be speaking at the American Academy of Sleep Technologists (AAST) conference in June of next year. Read the rest of this entry »

Video Blog: Not as many people are using CPAP devices. Many patients are finding better results with newer devices…

“Government efficiency” is surely an oxymoron, but think again, because the government is extremely efficient in wasting your tax dollars. Last week at the sleep lab, we conducted a repeat diagnostic sleep study in a Medicare patient (reimbursement ~ $800), which we believe was a complete waste of time and resources. Why did we have to repeat this study?

Because in the patient’s earlier split night study, in which this individual suffered from raging and life-threatening sleep apnea, the patient could only sleep for 87 minutes before we needed to switch over to PAP therapy, after having witnessed more than 100 apneas as well as repetitive oxygen desaturations below 60%.

The DME company claimed that Medicare would not cover the cost of the patient’s PAP device, because the individual needed 120 minutes of sleep to confirm the diagnosis of…did I mention it was raging life-threatening sleep apnea…

So, in the infinite wisdom of Medicare, an institution that imagines that sleep doctors don’t actually know what’s best for their patients, we were obliged to have the patient spend another night in the lab to confirm the diagnosis, because on the first night (split-night) we made the egregious mistake of being overly concerned with treating our patient for a serious medical condition and having enough time to complete a superior titration.

There ought to be a law!

Last month, we published an innovative approach to introducing PAP Therapy to our patients.  Published in the Journal of Clinical sleep Medicine (June 15, 2008 issue), we explore how a daytime procedure called the PAP-NAP can be used to help sleep apnea patients learn about the breathing mask treatment in a more comfortable environment.  We're already receiving phone calls from sleep centers around the country seeking to learn how to incorporate this step into their clinical settings.  In the future, we will be developing a 1-hr CME program to provide assistance to sleep medical providers and centers that want to use the PAP-NAP.

My research team will be in Baltimore for the annual APSS, presenting 5 works from the past year, including:

1. Oral presentation by me on the topic of “Sleep Disordered Breathing in Patients Dependent on Prescription Sleep Medications.”
2. Oral presentation by Eddie Romero on the topic of “Nocturia as a Screening Tool for Sleep-Disordered Breathing.”
3. Poster by Linda Trujillo on the topic of “Self-Guided Imagery for Insomnia Patients undergoing Polysomnography Testing.”
4. Poster by Natalia McIver on the topic of “Self-Guided Imagery for SDB Patients undergoing a Polysomnography Titration.”
5. Poster by Eddie Romero on the topic of “Nocturia as a Screening Tool in Insomnia Patients with Potential Risk for Sleep-Disordered Breathing.”