Exam (elaborations)
Clinical Evaluation and Management for the CCSH(questions and answers).
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Clinical Evaluation and Management for the CCSH(questions and answers).
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Clinical Evaluation andManagement for the
CCSH(questions and
answers)
Start with the Patient Meeting The Role of the
CCSH - answer Family support
Discussion of symptoms'
Review options for In-Center vs home testing
Provide literature for review
Document for physician review
Indications for Sleep Testing - answer In Center vs
Home Sleep Testing
Best option for the patient Affordability Physical
Needs
Steps for test approval
Review office notes
Review order for coding accuracy
,Use Choosing Wisely® recommendations from the
ABIM: - answer Helps to "promote conversations
between clinicians and patients by helping identify
evidence-based care that is truly necessary and
free from harm"
When to avoid PSG - answer in chronic insomnia
patients unless symptoms suggest a comorbid
sleep disorder."
primary therapy for chronic insomnia - answer
cognitive-behavioral therapy, and reserve
medication for adjunctive treatment when
necessary"
"Avoid use of hypnotics as primary therapy -
answer chronic insomnia
Utilize ABIM Choosing Wisely® Recommendations -
answer "Don't use polysomnography to diagnose
restless legs syndrome, except rarely when the
clinical history is ambiguous, and documentation of
periodic leg movements is necessary"
Utilize ABIM Choosing Wisely® Recommendations -
answer "Don't perform positive airway pressure re-
titration studies in asymptomatic, adherent sleep
apnea patients with stable weight"
, AASM Clinical Practice Standards - answer Provide
guidance for evaluation, diagnosis, treatment and
patient follow-up for sleep disorders
AASM Clinical Practice Standards - answer Assist
clinicians in making better decisions on whether
attended polysomnography or home sleep apnea
testing should be performed for suspected
obstructive sleep apnea
Polysomnography To diagnose or assess the
treatment of sleep disorders such as: - answer
Sleep apnea
Hypersomnia
Narcolepsy
Parasomnias / Seizures
Movement disorders
Pediatric sleep disorders
AASM guidelines recommend in- center testing be
used for diagnosing OSA in patients with: In center
testing recommendation - answer significant
cardiorespiratory disease
neuromuscular conditions
hypoventilation (awake or sleep- related) •
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