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Sleeping at Home

Ilene M. Rosen, MD, MSCE, FCCP; Scott Manaker, MD, PhD, FCCP
Author and Funding Information

Correspondence to: Ilene M. Rosen, MD, MSCE, FCCP, University of Pennsylvania School of Medicine, Penn Sleep Centers, 3624 Market St, Suite 205, Philadelphia, PA 19104; e-mail: ilene.rosen@uphs.upenn.edu

Dr. Rosen is Assistant Professor, Divisions of Sleep Medicine and Allergy and Critical Care, and Dr. Manaker is Professor, Division of Allergy and Critical Care, Department of Internal Medicine, University of Pennsylvania School of Medicine.

Dr. Rosen has no conflict of interest to disclose. Dr. Manaker has been a Grand Rounds speaker, lecturer, consultant, and expert witness on documentation, coding, billing, and reimbursement to hospitals, physicians, departments, practice groups, professional societies, and attorneys (defense, plaintiff “qui tam,” US Attorneys General, and the Office of the Inspector General). He is a consultant to Pfizer and Johnson & Johnson. He acts as an expert witness in workers' compensation and in medical negligence matters. He also holds stock in Neose Technologies, Pfizer, Johnson & Johnson, and Rohm & Haas.


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2008;134(4):680-682. doi:10.1378/chest.08-1799
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The diagnostic paradigm for obstructive sleep apnea (OSA) in the United States is shifting. The Centers for Medicare and Medicaid Services (CMS) recently expanded the national coverage decision for continuous positive airway pressure (CPAP) therapy for patients with OSA.1 Medicare now covers CPAP for a beneficiary with a sleep apnea diagnosis based on clinical evaluation along with positive attended sleep laboratory polysomnography results, or a positive result using a type II, type III, or type IV unattended home sleep apnea monitoring device. Medicare beneficiaries now join the Veterans Administration and managed-care patient populations who have benefited from unattended portable sleep monitoring (PSM) for sleep apnea testing. However, the Medicare CPAP therapy benefit is initially covered only for 12 weeks pending an assessment of clinical efficacy for the patient.

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