Sleep & the Stark Law

Increasing Risk to Patients

Many Americans sacrifice sleep for their daily responsibilities. Unfortunately, for millions of people in the United States, a good night’s sleep is not choice at all; due to sleep diseases such as obstructive sleep apnea (OSA), treatment can be physically unattainable without receiving the high quality care of a board certified sleep specialist.

Have you heard about the dangers of OSA? The stakes are high, as the comorbid conditions of untreated OSA are far more severe than you may think. Studies have shown that OSA leads to increased risk for heart attack, stroke, hypertension, and type 2 diabetes. As many barriers stand between Medicare patients and proper OSA treatment, senseless and outdated laws cannot continue to burden American patients even further. Through creating an exception for the Stark Law for sleep medicine, qualified physicians can treat their Medicare patients continuously from diagnosis through therapy, protecting millions from potentially lethal comorbid diseases.

Heart Disease

“…OSA contributes to or exacerbates cardiovascular disease, and thus may be a novel target for cardiovascular risk reduction”
Monahan & Redline, 2011 2

Stroke

“Prospective studies have shown that obstructive sleep apnea is associated with an increased risk for stroke and early death”
Sahlin, Sandberg & Gustafson et al., 2008 3

Stroke

“Prospective studies have shown that obstructive sleep apnea is associated with an increased risk for stroke and early death”
Sahlin, Sandberg & Gustafson et al., 2008 3

Alzheimer’s

“…the incidence of sleep disorders… is increased in patients with Alzheimer’s Disease (AD) and continuous positive airway pressure (CPAP) therapy may slow or improve cognitive functioning in patients with AD and sleep disordered breathing”
Lucey & Bateman, 2014 4

Diabetes

“…OSA may be a novel risk factor for type 2 diabetes and/or, conversely…chronic hyperglycemia may promote OSA”
Tasali et al., 2008 1

Hypertension

“Resistant hypertension occurs in 15-20% of treated hypertensive patients, and 70-80% of resistant hypertensive patients have obstructive sleep apnea (OSA)”
Min et al., 2015 5

For all questions, comments, and opportunities for collaboration, please contact AASM advocacy staff (policy@aasm.org) at (630) 737-9700.

1. Tasali, Esra. “Obstructive Sleep Apnea and Type 2 Diabetes *.” Chest CHEST Journal 133.2 (2008): 496. Web.
2. Monahan, Ken, and Susan Redline. “ROLE OF OBSTRUCTIVE SLEEP APNEA IN CARDIOVASCULAR DISEASE.” Current Opinion in Cardiology 26.6 (2011): 541–547. PMC. Web. 12 Oct. 2015.
3. Sahlin C, Sandberg O, Gustafson Y, et al. Obstructive Sleep Apnea Is a Risk Factor for Death in Patients With Stroke: A 10-Year Follow-up. Arch Intern Med. 2008;168(3):297-301. doi:10.1001/archinternmed.2007.70
4. Lucey, Brendan P., and Randall J. Bateman. “Amyloid-β Diurnal Pattern: Possible Role of Sleep in Alzheimer’s Disease Pathogenesis.” Neurobiology of Aging 35 (2014): n. pag. Web.
5. Min, Hyun Jin et al. “Clinical Features of Obstructive Sleep Apnea That Determine Its High Prevalence in Resistant Hypertension.” Yonsei Medical Journal 56.5 (2015): 1258–1265. PMC. Web. 12 Oct. 2015.