Bears and Bubbles: Prognosticating the Future of Sleep Technologists

摘要

Much as the polar bear represents a sentinel for the health of the arctic and is currently struggling with climate change,1 clinical sleep medicine appears to be entering a similar phase of adjusting to a new medical environment. Clinical sleep medicine has been a growth industry for at least the last 15 years: Laboratories opened, technologists were hired, and patients were tested and treated; this cycle was repeated throughout the country. The number of American Academy of Sleep Medicine-accredited sleep centers increased from approximately 500 in the year 2000 to more than 2000 in the year 2010. Medicare spending on polysomnography alone grew 4-fold in the years from 2001 to 2009, not including spending on clinical visits and durable medical equipment related to sleep medicine.2 However, as recently described by Drs. Epstein and Quan in this journal's editorial section,3 the economic growth wave of sleep medicine may be coming to an end. A portion of the financial slowdown is related to the approval by the Center for Medicare and Medicaid Services (CMS) of out of center sleep testing as a replacement for in-laboratory polysomnography; home-based tests typically generate significantly less revenue than their in-laboratory counterpart.2