IDS Sleep for Physicians
How IDS Sleep WorksThe IDS Home Sleep Testing process, known as IDS Sleep, is easy for patients and treating physicians. Start with a simple evaluation, then fax our referral form and we'll handle the rest; giving you time to make sure your patients are sleeping and feeling better!
Evaluating Patients for OSA
Patients with high risk factors such as obesity, large neck, high blood pressure, and diabetes may be candidates for Obstructive Sleep Apnea (OSA). In fact, evaluating patients for OSA is such a simple and quick process it could be considered for all adult patients. Clinically validated symptom screeners include the Epworth Sleepiness Scale (link), Berlin Questionnaire (link), and the STOP Questionnaire. You may also uncover the most prevalent symptoms by asking the patient simple questions such as: Do you snore? Are you excessively tired during the day? Have you ever been told you stop breathing during sleep? Do you ever wake up with a headache? Documenting symptoms either alone or especially in combination with the high risk factors listed above may lead to a high suspicion of OSA.
Document Your Findings
CMS has made it very clear that an assessment for OSA risks should be documented by the treating physician prior to referral for a Home Sleep Test (HST) and prescription of Continuous Positive Airway Pressure (CPAP). Simply discuss your suspicion of OSA (based on the findings above) with your patient and check the BMI and neck circumference. Examine the upper airway for soft tissue abnormalities (such as enlarged tonsils or asymmetry) or nasal obstruction and document your findings in the patient's chart. By signing the IDS referral form, you are confirming you understand the importance of this assessment in the process (see statement above signature).
Order HST for Appropriate Patients
To order an HST, simply send in an IDS order form completed and signed. We can also accept a standard pad script where the procedure is listed as "Home Sleep Test" with an appropriate sleep apnea diagnosis (in this case, please add a coverpage with patient demographics minimally including a contact phone number). Fax this paperwork to IDS at the number on the IDS order form.
An HST is only intended for patients who are found to be symptomatic of OSA during a clinical evaluation. The patient should be able to comprehend written instruction and be able to test unattended, or have a caregiver present that can aid with the test. Those with signicant co-morbidities such as severe COPD, CHF, or neurological issues should be considered for an in-lab sleep study. If other sleep disorders are suspected such as Restless Leg Syndrome (RLS), Narcolepsy, Insomnia, sleep walking, etc an HST is NOT appropriate and the patient would need to be evaluated using the appropriate methods.
The Testing Process
Upon receipt of your order, IDS contacts the patient and ships a ResMed ApneaLink+ (Type III) device to their home. The patient applies two sensors at bedtime: a slip-on finger pulse sensor; and a nasal cannula to record snoring and airflow. An instructional DVD and professionally illustrated instructions detailing each simple step are provided. Trained technicians are available for patient assistance toll-free, 24/7.
All test results are reviewed by a board certified sleep physician who interprets the results and makes recommendations for treatment based on the findings. The findings will be faxed and mailed to you in a easy-to-follow format after a typical turnaround time of 7-10 days from your initial order.
Next Steps & Treatment
Following a home study that confirms a diagnosis of OSA, a patient will typically be started on Positive Airway Pressure (PAP) therapy. The pressure settings may be determined through an Auto-titrating PAP (APAP) or a follow-up lab titration with a CPAP. You and your patient may work with a preferred local DME provider to ensure optimal care as well as documentation of PAP use & compliance (which is required for Medicare patients). You will need to follow up with your patient in person after 90 days of use, to evaluate the effectiveness of the treatment. For Practice Parameters recommended by the American Academy of Sleep Medicine (AASM) for implementing treatment using APAP, please visit the AASM website or use the following direct link (link to AASM site subject to change): http://www.aasmnet.org/Resources/PracticeParameters/PP_Autotitrating_Update.pdf
You’ll be amazed at how easy it is to uncover and treat sleep disorders in your patients, and how well their improved sleep correlates to other areas of their health.