Split-Night Polysomnography

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.