The number of people in Massachusetts living with obstructive sleep apnea would fill Fenway Park 10 times over. Sadly, the majority of them don’t know it and fewer still are being treated. Most in the Bay State have either never heard of the condition or think it merely means loud snoring that keeps spouses up at night. Sleep apnea is, however, a serious health condition, more common in the United States than diabetes, and it is known to cause or aggravate diabetes and high blood pressure, lead to obesity, raise the risk of heart attack and stroke, and cause fatal traffic accidents from the lack of restful sleep.
However, sleep apnea continues to fly under the radar. This is a shame, since addressing this disease, with its connections to the country’s most expensive health conditions — obesity, diabetes and heart disease — reduces health care costs and improves the quality of life for millions. This is an especially timely consideration, given the recent measures taken by the Massachusetts Legislature to control rising health care spending. More importantly, it would make millions of Americans much healthier.
This week, Boston is host to the largest meeting of sleep specialists in the world, SLEEP 2012, where experts will be focused on advancements in diagnosis and management of sleep apnea, in addition to other sleep disorders. Despite the advancement in medical science in this field, a startling 85 percent of sufferers with moderate to severe sleep apnea remain undiagnosed and therefore untreated. Prevalence in the United States is rising due to increasing childhood and adult obesity, making improved access to diagnosis a necessity.
Massachusetts health providers and health plans are making major strides toward managing this condition – but access and affordability of testing are obstacles to diagnosis today. Diagnosis and treatment planning required in the past one to two expensive and uncomfortable overnight stays in a hospital sleep laboratory.
Fortunately, there are now devices that can accurately diagnose sleep apnea when used in the patient’s home. Their use was pioneered here in Massachusetts in the late 1980s and now they are becoming the preferred pathway for many patients. The privacy, lower cost, widespread availability and the comfort of testing in one’s own bed are very attractive. The most advanced devices provide the data to the doctors wirelessly, expediting the diagnosis and therapy. Such at-home testing will increase the number of patients identified and successfully treated, as well as free up expensive sleep laboratory resources for other sleep problems and more medically complex patients.
The Commonwealth’s health providers and plans have been leading the way, instituting programs that facilitate access to portable testing and covering them for the majority of patients. Fallon Community, Tufts and Harvard Pilgrim Health Plans, for example, have encouraged the transition to at-home sleep testing for the majority of their patients. This has allowed Massachusetts sleep specialists to be among the first in the country to experience the benefits of applying sleep center expertise to out-of-center (in-home) testing capabilities.
During this week’s international conference, transition to in-home testing will be actively discussed and the experience in Massachusetts will be at the center of the debate. Economic and health care outcomes data compel us to aggressively seek out those with sleep apnea to reduce medical expenses for patients, payers, and employers alike. The quality of life in treated sleep apnea sufferers is dramatically improved, so removing barriers to care by transitioning testing to the patient’s home is critically important. Reducing cost and improving the health and happiness of the many Massachusetts sleep apnea sufferers should help us all sleep more soundly.
Dr. Michael Coppola is president and chief medical officer of the American Sleep Apnea Association, a certified sleep specialist, an associate clinical professor at Tufts University School of Medicine. He is also chief medical officer of NovaSom, Inc.