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4. 1 and 3
Many insurance companies will deny an overnight polysomnography (an in-lab sleep study) when an Epworth Sleepiness Scale is below a certain value, usually 10 (1). This was the case here. In order to get some documentation of sleep disordered breathing she had an at home sleep study performed which revealed an apnea-hypopnea index (AHI) of 8 events per hour which is consistent with mild OSA (2). Some might recommend an ENT referral but this is usually unnecessary unless there is a fairly obvious problem. She was reassured but wanted treatment for her daytime hypersomnolence.
What should be done at this time? (Click on the correct answer to proceed to the third of six pages)