Sleep Management Guidelines

Covers appropriate use of diagnostic sleep testing (HSAT, in‑lab PSG, MSLT, MWT), PAP therapies (CPAP/APAP/Bi‑level/ASV), hypoglossal nerve stimulator testing, pediatric PSG and oral appliances while excluding home/portable OSA testing in children, PAP‑NAP, stand‑alone actigraphy, several novel devices/therapies and miscellaneous DME items judged experimental/unproven. Key requirements include a treating provider clinical evaluation within 60 days and validated questionnaire results, HSAT technical adequacy of ≥4 hours of oximetry and flow, documented physiologic thresholds for PSG indications (e.g., BMI, ABG/PCO2, pulmonary/cardiac criteria), and PAP adherence evidence of ≥4 hours/night on ≥70% of nights over a consecutive 30‑day period with device download data (ASV is contraindicated with EF ≤45% and moderate–severe CSA).

"A current and comprehensive clinical evaluation (within 60 days) by the treating medical provider, either face to face or telehealth, is required before a sleep study can be considered."