Abbreviated Daytime Sleep Study (e.g. PAP-NAP)
DESCRIPTION
An abbreviated daytime sleep study (PAP NAP) has been explored to address poor compliance and enhance individual comfort and tolerance of CPAP/BiPAP. PAP NAP combines psychological and physiological treatments into one procedure during an abbreviated daytime nap session (100-120 minutes). Sleep technicians employ various coaching and monitoring techniques including mask and pressure desensitization, emotion focused therapy to overcome aversive responses to CPAP, mental imagery to divert the individual’s attention from the sensations associated with CPAP and physiological exposure to CPAP.
Overnight polysomnography (PSG) testing is the standard diagnostic test performed for both adult and children. Despite efforts to individualize the treatment, adherence to prescribed therapy (e.g., CPAP, BiPAP) remains tenuous.
POLICY
An abbreviated daytime sleep study (PAP-NAP) used as a supplement to standard sleep studies for all indications, including but not limited to, the following is considered investigational:
Correcting non-compliance, or improving compliance with prescribed CPAP
Decreasing anxiety/claustrophobia associated with CPAP
Patient education
Mask and pressure desensitization
Cognitive behavioral therapy (CBT)
IMPORTANT REMINDERS
Any specific products referenced in this policy are just examples and are intended for illustrative purposes only. It is not intended to be a recommendation of one product over another and is not intended to represent a complete listing of all products available. These examples are contained in the parenthetical e.g. statement.
We develop Medical Policies to provide guidance to Members and Providers. This Medical Policy relates only to the services or supplies described in it. The existence of a Medical Policy is not an authorization, certification, explanation of benefits or a contract for the service (or supply) that is referenced in the Medical Policy. For a determination of the benefits that a Member is entitled to receive under his or her health plan, the Member's health plan must be reviewed. If there is a conflict between the Medical Policy and a health plan or government program (e.g., TennCare), the express terms of the health plan or government program will govern.
ADDITIONAL INFORMATION
Limited data from a single study of PAP-NAP is insufficient evidence to form conclusions on the efficacy of this approach in improving compliance with CPAP. No professional guidelines currently recommend use of PAP NAP as a compliance enhancement for either adults or children.
SOURCES
American Academy of Sleep Medicine. (2017). Diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine clinical practice guideline. Retrieved April 25, 2017 from http://www.journalsleep.org.
American Academy of Sleep Medicine. (2021). Use of polysomnography and home sleep apnea tests for the longitudinal management of obstructive sleep apnea in adults: an American Academy of Sleep Medicine clinical guidance statement. Retrieved August 17, 2022 from http://www.aasm.org.
BlueCross BlueShield Association. Evidence Positioning System. (7:2023). Medical Management of Obstructive Sleep Apnea Syndrome (8.01.67). Retrieved October 4, 2023 from www.bcbsaocaoca.com/eps/. (48 articles and/or guidelines reviewed)
Centers for Medicare & Medicaid Services. CMS.gov. NCD for sleep testing for obstructive sleep apnea (OSA) (240.4.1). Retrieved June 29, 2016 from https://www.cms.gov.
Krakow, B., Ulibarri, V., Melendrez, D., Kikta, S., Togami, L., & Haynes, P. (2008). A daytime, abbreviated cardio-respiratory sleep study (CPT 95807-52) to acclimate insomnia patients with sleep disordered breathing to positive airway pressure (PAP-NAP). Journal of Clinical Medicine, 4 (3), 212-222. (Level 4 evidence)
ORIGINAL EFFECTIVE DATE: 2/9/2014
MOST RECENT REVIEW DATE: 11/9/2023
ID_BA
Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.
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