Posted by Mark Honor on November 26, 2001 at 21:33:10:In Reply to: Article on "Comparison of split night vs. all night studies posted by Wolf on October 16, 2001 at 22:25:03:
I am a registered sleep tech and I'm also a PA(physician assistant) I work for pulmonary docs who oversee 2000 sleep tests per year and see about 4-5,000 sleep related visits each year. I personally see 30-40 private sleep paients a week. We have to use split night tests in about 80% of our tests for many reasons, financial reasons being the most important. Most insurers in the new york metro area will only pay for one test,therefore, if you have to do a second test you must absorb the cost. If you work in a market where you can get away with billing for two tests then it may or may not be beneficial. I am speaking from experience with regard to the NY market. A split night study is great if you have a good technical staff and your lab is overbooked. For example, in most NYC area sleep labs there is a one to three month wait for an NPSG (Unless you want an in home study ---which is another topic all to itself) With this in mind it is impractical to do 2 tests and it may also be a medical legal issue too if you have a pt with severe OSAS. For example, if you identify a paitent with severe OSAS then you send them home with the intent to repeat the test with CPAP, What happens if that guy kills someone in a car accident? or what if this guy doesn't want to repeat the test then he has an MI? From my standpoint, the split night test needs be implemented about 80% of the time for cost effectiveness, patient satisfaction, and medical legal reasons. And to answer the original quesiton, Yes there was an article published in SLEEP around 1997 about split night testing.
Mark Honor, RPA-C, R.PSG.T.
Brooklyn, NY