Sleep Management Guidelines

Covers diagnosis and management of sleep‑disordered breathing—including criteria for HSAT vs in‑lab PSG, PAP device selection/titration, adult oral appliance use, required screening questionnaires, follow‑up, and many exclusions (HSAT unproven in children; listed experimental therapies such as Bongo Rx, iNAP, eXciteOSA, MATRx; and certain DME/unlisted codes CPT 94799, HCPCS E1399, K1001). Key requirements: a treating provider evaluation within 60 days plus validated questionnaire or proxy findings; HSAT only for high pretest probability and adequate patient ability to use equipment; PSG required for specified comorbidities (OHS, severe pulmonary disease, CHF, pulmonary hypertension, neurologic disease, chronic severe insomnia, suspected CSA/narcolepsy criteria, etc.); PAP initiation/replacement requires documented compliance (≥4 hrs/night on 70% of nights for 30 consecutive days within the first 3 months) and device failure/out‑of‑warranty for replacement, with strict documentation and limits on repeat testing and accessory replacement frequencies.