Does Health Insurance Cover Sleep Studies?
Sleep studies may be covered by your health insurance plan, although each policy differs by state and the particular plan you have. Health Magazine notes that most insurance companies will cover sleep studies to help determine if you have some type of sleep disorder, but they may not be as quick to cover treatment for every disorder.
Some of the more common disorders that can pose serious health threats, such as sleep apnea, are more likely to be covered than others. Although likely to be covered, sleep studies may also come with a host of stipulations you must follow to ensure you are eligible for coverage.
What stipulations may I have to follow for sleep study coverage?
Coverage for a sleep study may only be possible if you first get a referral from your primary care doctor, according to Froedtert Health. You may also have to get pre-certification from your insurance company before you schedule and take part in the study.
Your insurance company may also have a network of participating providers that offer sleep studies. In order to be covered, or at least get the most cost-effective rates, you may have to choose from providers within the network.
What occurs in a sleep study?
In sleep studies, trained professionals monitor your sleep to determine if you have any disorders or issues. You typically show up at the sleep center in the evening, meet with a technician who will be monitoring the equipment, and then prepare to spend the night at the center. Sleep centers generally offer each study participant a private room in which to sleep, although it may have a window looking into the main control room.
Before going to sleep, the technician will go over the details of the study and any equipment you may need to use or wear during your study. You may have leads hooked up to various areas on your body or measurement devices. It usually takes less than one hour to outfit you with the necessary devices.
Your study may include devices that monitor all types of movements during your sleeping period, the Mayo Clinic explains. These can include recurring leg motions, heart rate, eye movements, breathing rate, blood oxygen levels, and brain waves. They can also record other movements that may be unusual for the average person and are an indication of a sleep disorder.
Once outfitted, you get time to read, watch TV if available, or otherwise relax until bedtime. Once you fall asleep, the technician will continuously monitor your sleep, keeping an eye on the devices and other indicators that let him or her know if any events that indicate a disorder occur.
If any sign indicates an event linked to sleep apnea, the technician may wake you up to outfit you with a CPAP mask. The device, technically known as a continuous positive airway pressure mask, allows the technician to help your throat stay open by controlling the amount of air pressure in the mask. You then go back to sleep, with the technician starting off the CPAP mask with low pressure and slowly increasing it to higher amounts of pressure.
Another sleep study option mentioned by the Los Angeles Times is undergoing a sleep study at home. Your insurance company is more likely to cover a study done in a sleep center’s lab, however, even though the overall cost of the home sleep test may be lower. The sleep center’s study usually goes into greater details on any issues than a home test can, offering more comprehensive results.
What are some signs that I may have a sleep disorder?
You may be exhibiting signs of a sleep disorder that can be apparent even before you take a sleep study. Snoring is often a prime indication of a sleep disorder as it can link back to an obstruction in your airway. This holds especially true if you happen to have high blood pressure or suffer from other cardiovascular disease issues.
Another red flag is if you ever stop breathing during your sleep. While you may have no clue whether or not you stop breathing during sleep or not, anyone who sleeps in the same room with you may be able to tell you if you do.
Additional signs that could indicate a sleep disorder include being extremely groggy, irritable, or remaining tired even after getting at least 10 hours of sleep. Insomnia is often linked to sleep disorders, as are kicking, thrashing, or moving around continuously throughout the night. Your driving abilities and skills can also suffer, with one more red flag being close calls when it comes to accidents or crashes.
Sleep apnea is just one of the more than 80 sleep disorders that sleep studies can help diagnose. Snoring on its own is not considered a disorder, although it can be an indication of one. Sleep study results generally take at least two weeks to receive. If you are diagnosed with a sleep disorder, the next step is for a specialist to determine and devise a treatment plan that may help with your specific issues.