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Out-of-Center Sleep Testing

Indications:

Out-of-Center Sleep Testing, or OCST, is an at home sleep assessment indicated for

  • Adults with high pretest probability of moderate to severe Obstructive Sleep Apnea (OSA)
  • Adults whose immobility prevents in-Center testing
  • Monitoring of patients response to non-CPAP treatments for Obstructive Sleep Apnea, including oral appliances, upper airway surgery, and weight loss.

Contraindications for OCST

OCST is contraindicated for the following:

  • Pediatric patients (<18 years of age)
  • Patients with comorbid medical conditions (i.e. COPD, moderate to severe pulmonary disease, neuromuscular disease, or congestive heart failure)
  • Patients with suspected non-OSA sleep disorders such as Central Sleep Apnea, Restless Leg Syndrome, insomnia, parasomnias (i.e. sleep walking), and narcolepsy
  • Medical or cognitive issues that impact the safety of a patient using the device unattended
  • Inability to sleep at least 6 hours per night
  • Head circumference less than 20 inches or greater than 25 inches
  • Current upper respiratory infections or congestion
  • Patients using oxygen
  • Patients with tics or tremors of the head
  • For general screening purposes

Patient Screening

The patient must have a face-to-face clinical evaluation by the treating physician prior to the sleep test to assess the patient for Obstructive Sleep Apnea. In addition to the physical examination, there are several validated screening questionnaires available to determine if a patient is a candidate for OCST. Validated screens include the Epworth Sleepiness Scale, the Berlin Questionnaire, and the Watermark ARES Risk Evaluation.

Out-of-Center Sleep Testing (OCST)

The testing is performed using an unattended Type III portable monitoring sleep study device which will monitor your patient for Obstructive Sleep Apnea (OSA). Parameters that are measured include simultaneous airflow, respiratory events, pulse rate, oxygen saturation, head position/movement, arousal indicators, snoring, sleep/wake, REM/NREM, apnea/hypopnea index, and sleep time.

How to Schedule a Patient for OCST with the Sleep Disorders Center of Community Hospital Anderson

Documentation required for scheduling a patient for an OCST:

  • Physicians order for a home sleep test with the number of testing nights (1-3 nights) indicated on the order
  • Patient history and physical
  • Face-to-face clinical evaluation notes from the office visit
  • Medication list

Precertification Process:

The precertification process should begin the day the patient is scheduled for their OCST or after a denial for in-lab diagnostic testing is received. Patients may be scheduled for testing quickly for convenience.

Our Type III testing devices are approved for the following procedure codes

  • 98500 (private insurance)
  • G0399 (Medicare)

Patient Testing Procedure

Patients ordered and approved for OCST will be scheduled to come into the Sleep Disorders Center at Community Hospital Anderson to be educated on the application and use of the device by a Registered Polysomnogram sleep technologist. The patient applies the equipment later that evening and undergoes a sleep study in the comfort of their home. After the ordered number of nights (1-3 nights) has been recorded and the patient returns the device to the Sleep Disorders Center, the data is downloaded for scoring, reporting, and interpreted by a board certified sleep specialist. Our sleep specialist will then recommend and order any additional testing or treatment.