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Split-Night Polysomnography^*

^* From the Division of Pulmonary, Critical Care & Allergy, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA.

Correspondence to: Nirav P. Patel, MD, Division of Sleep Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Hospital of the University of Pennsylvania, 973 Maloney Building, 3600 Spruce St, Philadelphia, PA 19104; e-mail: nirav.patel{at}uphs.upenn.edu

Abstract

Obstructive sleep apnea (OSA) is a common disorder associated with serious health consequences, increased health-care utilization, and economic burden. With greater public and medical attention to sleep disorders, the volume of referrals for sleep studies over the last decade has increased by approximately 12-fold. Despite the steep growth of infrastructure to diagnose and treat OSA, access to such services remains a sizeable problem, and demand overwhelms capacity. To expedite diagnosis of sleep apnea and prescription of treatment, one strategy adopted by sleep specialists is to employ split-night polysomnography, a strategy that encompasses both diagnosis of OSA and initiation of positive pressure therapy in a single night. This article reviews the literature examining this combined diagnostic/therapeutic strategy and discusses the applicable third-party issues of procedural coding and reimbursement.

Key Words: apnea-hypopnea index • continuous positive airway pressure titration • obstructive sleep apnea • polysomnography • respiratory disturbance index • split-night polysomnography • third-party payer

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