Rupee-1
January 20th, 2017 by sleepcureblog

 

We at Sleep Cure Solutions get frequent calls from patient’s who have been advised Sleep Study by their GP/Doctor. The most common question asked is “How much will the Sleep Study cost ?This is  part of an exercise they embark upon trying to check and compare the cost with various service providers .The answer to this question is so baffling that it leaves them even more confused. We regularly get patients who are quoted anywhere from 2,000 to 20,000 Rupees for a Sleep Study !!!

To get them out of this dilemma and to Empower them I am elaborating on some key points about the Costs of Sleep Studies.

- At present time none of the health insurances in India cover the cost of a sleep study thus it is mostly out of pocket expense.

- There are different levels of Sleep Studies and all sleep studies are not the same.
- A level 1 sleep study (Polysomnography) is an in lab sleep study. The costs of this can vary depending upon the hospital it is being done and the cost in Delhi /Gurgaon/NCR vary between Rs 15000 to 20000. Although it has been the ‘gold standard’ for long but advancements in technology and the portability many patients may not require and can avoid having to sleep in a lab. However patients with co-morbidities should undergo in-lab study.
- Home sleep test (HST) – these are gaining popularity around the world. It should be emphasized that all HST’s are not the same.
- A comprehensive Home Sleep Study (attended level 2 study) is the most popular level of testing. This involves a trained technician putting on the leads and sensors and observing the sleep in your bedroom. The titration is done wherever required. This sort of testing is not possible in the West where it is not possible to have techs staying overnight thus does not find much mention in the medical literature. Sleep Cure Solutions team has the experience of over 3000 such tests and have mastered this testing pathway. These tests typically costs between Rs 8000 – Rs 12000.
- Level 3 sleep tests (unattended level 3 HST) are self- administered (sometimes techs may be asked to administer this just to jack up the costs) sleep tests to rule in Sleep Apnea and are done where the Sleep Apnea is very obvious and there are time and cost constraints. There is no monitoring of sleep (no EEG, EMG, EOG) but just the cardio-respiratory parameters during sleep. There is no provision for titration in this. These tests cost between Rs 2000 to Rs 5000.
As with any other modality it is very important to understand & ensure some of the basics and things like who is recommending the test, who is going to do it, what are the credentials of the Sleep Physician etc.Unfortunately the Sleep Medicine Healthcare Sector is unregulated and Vendors (suppliers of CPAP machines) are doing Sleep studies left right and centre often at throw away prices without really understanding the science and leaving behind a trail of unsatisfied customers. They often have ‘fixed reports’ all advising buying a CPAP machine
As an empowered customer it is your duty and right to get the best service that your money can buy but that would mean doing your homework.
Sleep Cure Solutions with it’s unique business model of utilizing the strength of our backend operations( helping subsidize our local work) is able to provide services at about 30% less cost to the patients. We have been at the forefront of training and are playing a pioneering role in the emergence of Sleep Medicine. The service is led by an American Board Certified Sleep Physician  who has been mentoring physicians in this region. We feel happy and privileged to pass on the benefits of our business model, and our expertise to our patients.

Author :Dr Prerana Garg is the Medical Director at Sleep Cure Solutions. She believes that by doing full disclosure and transparency about everything we do in our practice–especially when it comes to cost we can build trust with our patients and we should not shy away from it.

Posted in Sleep Study Tagged with: , , , , , , , , , , , , ,

healthy sleep habits and tips
November 7th, 2016 by Sleep Cure Solutions

We spend almost one-third of our life sleeping. And if you try to combine the hours we sleep in our life time, it’s huge, it’s really huge.

But why do we sleep every day? What makes us feel sleepy every night? And why do we feel good when we wake up from a full night’s sleep?

These questions need answers – and for centuries, the curious species, we-the-mankind, have been trying to decode sleep. Read more of this article »

Posted in SCORING, Sleep Study Tagged with: , , ,

April 29th, 2015 by sleepcureblog

Rupee-1

We at Sleep Cure Solutions get frequent calls from patient’s who have been advised Sleep Study by their GP/Doctor. The most common question asked is “How much will the Sleep Study cost ?This is  part of an exercise they embark upon trying to check and compare the cost with various service providers .The answer to this question is so baffling that it leaves them even more confused. We regularly get patients who are quoted anywhere from 2,000 to 20,000 Rupees for a Sleep Study !!!

To get them out of this dilemma and to Empower them I am elaborating on some key points about the Costs of Sleep Studies.

- At present time none of the health insurances in India cover the cost of a sleep study thus it is mostly out of pocket expense
- There are different levels of Sleep Studies and all sleep studies are not the same.
- A level 1 sleep study (Polysomnography) is an in lab sleep study. The costs of this can vary depending upon the hospital it is being done and the cost in Delhi /Gurgaon/NCR vary between Rs 15000 to 20000. Although it has been the ‘gold standard’ for long but advancements in technology and the portability many patients may not require and can avoid having to sleep in a lab. However patients with co-morbidities should undergo in-lab study
- Home sleep test (HST) – these are gaining popularity around the world. It should be emphasized that all HST’s are not the same.
- A comprehensive Home Sleep Study (attended level 2 study) is the most popular level of testing. This involves a trained technician putting on the leads and sensors and observing the sleep in your bedroom. The titration is done wherever required. This sort of testing is not possible in the West where it is not possible to have techs staying overnight thus does not find much mention in the medical literature. Sleep Cure Solutions team has the experience of over 3000 such tests and have mastered this testing pathway. These tests typically costs between Rs 8000 – Rs 12000.
- Level 3 sleep tests (unattended level 3 HST) are self- administered (sometimes techs may be asked to administer this just to jack up the costs) sleep tests to rule in Sleep Apnea and are done where the Sleep Apnea is very obvious and there are time and cost constraints. There is no monitoring of sleep (no EEG, EMG, EOG) but just the cardio-respiratory parameters during sleep. There is no provision for titration in this. These tests cost between Rs 2000 to Rs 5000.
As with any other modality it is very important to understand & ensure some of the basics and things like who is recommending the test, who is going to do it, what are the credentials of the Sleep Physician etc.Unfortunately the Sleep Medicine Healthcare Sector is unregulated and Vendors (suppliers of CPAP machines) are doing Sleep studies left right and centre often at throw away prices without really understanding the science and leaving behind a trail of unsatisfied customers. They often have ‘fixed reports’ all advising buying a CPAP machine
As an empowered customer it is your duty and right to get the best service that your money can buy but that would mean doing your homework.
Sleep Cure Solutions with it’s unique business model of utilizing the strength of our backend operations( helping subsidize our local work) is able to provide services at about 30% less cost to the patients. We have been at the forefront of training and are playing a pioneering role in the emergence of Sleep Medicine. The service is led by an American Board Certified Sleep Physician  who has been mentoring physicians in this region. We feel happy and privileged to pass on the benefits of our business model, and our expertise to our patients.

Author :Dr Prerana Garg is the Medical Director at Sleep Cure Solutions. She believes that by doing full disclosure and transparency about everything we do in our practice–especially when it comes to cost we can build trust with our patients and we should not shy away from it.

Posted in Sleep Study Tagged with: , , , , , , , , , , , , , ,

December 12th, 2014 by sleepcureblog

  What is a Sleep Study?

Sleep study is an overnight observation of an individual’s sleep.  This involves monitoring number of physiological parameters simultaneously like  EEG (brain activity), the eye moments (EOG), the chin tone (EMG), breathing (nasal flow), breathing efforts, Oxygen level, heart rhythm (ECG).

Sleep is not a unitary phenomenon .It is divided into different stages like REM sleep (dreaming sleep) and Non REM sleep which is further subdivided into three stages.  The nature has made sleep like an orchestra with different notes at different points and diseases like Sleep Apnea disrupt this rhythm. This can be easily deciphered by a well conducted comprehensive sleep study.

What are different levels (types) of Sleep studies?

There are 4 types -

Level 1 study being the gold standard where are all the above mentioned parameters are observed and attended to by a well-trained sleep technologist  and the recordings are scored by scoring technologists and reviewed by Sleep physician who interprets the same and provides with the final diagnosis and recommendation. The Sleep Specialist then discusses the report and advises the next line of treatment.

Level II study is similar to level 1 but not attended by the sleep technologist  and therefore there is a possibility of potential loss of data.

Level III study involves monitoring  of just two parameters mainly the breathing  and the Oxygen level without monitoring the brain activity and the sleep.

Level IV study is only monitoring the Oxygen level overnight.

In most situations Level 1 study is required however sometime the Sleep physician may conduct a simpler test.

What are the different forms of Sleep Studies?

Diagnostic studies - In these only the diagnostic gear is used; this can be level 1 to level IV study.

Titration studies – which involve titration with CPAP or the BiPAP :this can be performed only in level 1 study setting .

Sleep studies are generally conducted in a split night format in which the first part of the night is the Diagnostic arm and in the later half Therapeutic part where titration with CPAP is done. Split night studies are only possible with the level 1 format where a trained sleep technologist will conduct this study under the guidance of a Sleep Specialist.

 

Sleep study is a very powerful monitoring tool which gives us opportunity to peep into one’s mind and health. It’s utility goes much beyond diagnosing simple Sleep Apnea and extends to diagnosing conditions like periodic limb movement, Sleep architecture problems, Parasomnias, Complex Sleep Apneas, Bruxism, loss of REM Atonia etc.

Eyes cannot see what our mind does not know” is old saying very apt for the field of Sleep Medicine in the region. Device companies in order to fuel the growth of devices are trivializing the sleep diagnostics pushing vendors to conduct sleep studies in a completely unregulated environment; the quality of these can put any regulator to shame. Nevertheless each patient need to be an empowered consumer and decide for themselves what is best for their health.

Who needs a sleep study:

People complaining of the following symptoms need to be screened for Sleep Apnea and may require a Sleep Study

  • Snoring
  • Episodes of choking in the night
  • Morning headaches
  • Unrefreshing /Disturbed Sleep
  • Abnormal movements during night
  • Excessive Daytime Sleepiness.
  • Patients with comorbid conditions like Diabetes, heart failure, depression, fibromyalgia, atrial fibrillation, obesity

Author: Dr Himanshu Garg

Posted in Patient Information Tagged with: , , , , , , , , , , ,

December 7th, 2014 by sleepcureblog

It is wee hours of the morning and the clock has just struck 2 am, but for Ms Anita  sleep is still elusive. She has spent hours tossing and turning in the bed trying to switch off from work. Her stress is further escalating thinking of next day’s engagements and the impact lack of sleep would have on them. Her anxiety is further attenuating any chances of sleep. She somehow manages to get through the next day but starts to get anxious walking to her bedroom that night and this cycle repeats itself. Things eventually reach a stage when the very thought of sleep makes her anxious. Thanks to our booming economy more and more are finding themselves entrapped in this web and turning into insomniacs leading to an insomnia epidemic. Ideally the economic prosperity of a society should not be achieved at the cost of a massive sleep debt of its people but we have already gone too far out. Nonetheless the nature, significance and myriad causes of sleep difficulty remain poorly understood by health care providers and the public at large.

In the modern society sleep should be equated to charging our mobiles, which is very much an active process and not merely a state of rest. Lack of proper charge would only impair its working and utility the next day. Insomnia definitions have been similarly widened from simply meaning lack of initiating or maintaining sleep to include its daytime consequences. These include fatigue, excessive daytime sleepiness, social and occupational impairment, irritability and mood changes. All of these consequences place a considerable economic burden on its sufferers, their employers, health care system and the society.

Insomnia can be either acute or chronic. While most of us might have experienced acute insomnia as a transient problem that resolves quickly when precipitating circumstances like stress, sudden schedule changes or transient illness abates but one has to be careful and it should not be always taken lightly as most of the chronic insomnias start as acute condition as illustrated.

Insomnia can also be classified as either primary or co-morbid. Wherever an underlying cause can be found it is called co-morbid insomnia. Some of the common culprits are acute or chronic pain, chronic medical or psychiatric ailments, drugs or substance use. Often a definite cause cannot be found and primary insomnia is assumed. We are only beginning to unmask the mysteries of its causes and at this stage it appears that it might be an end result of appropriate environmental exposure in genetically predisposed individuals. The clinical assessment of insomnia is based on a careful interview, often supplemented by questionnaires, psychological testing and sleep diaries. At times an overnight polysomnography may be required which means sleeping in a controlled and observed environment in a sleep laboratory where the physician is able to record the brain waves and many other parameters in order to compute total amount of time spent in different stages of sleep.

It must be strongly emphasized that sleeping pill are not the management of choice for insomnia and should be used only as a last resort. Besides problems like adverse effects and habit-forming tendency they do not completely mimic the natural sleep. For example   the most commonly used sleeping pills, benzodiazepines, have a tendency to decrease the percentage of slow wave or deep sleep thus diluting the refreshing effect of sleep. Therefore rather than applying the ‘band-aid’ of a sleeping pill every attempt should be made to hunt down and treat the cause. In cases where this is not successful foremost attention should be paid to good sleep hygiene. This involves having a regular sleep-wake schedule, ensuring a comfortable sleeping environment (18- 22C is ideal), eliminating any noise and light, avoiding any tea, coffee or alcohol before sleeping, avoiding naps and resisting looking at the clock in the night. It is amazing how effective these simple steps alone can be in helping to solve the problems of so many people.

Cognitive behavioral therapy is the next therapeutic option. It employs different approaches leading to changes in behavior or cognition to improve sleep. It seeks to eliminate irrational beliefs about sleep and fears of not sleeping.

When nothing else seems to be working and drugs seem to be the only option left, it is best to discuss the options with your physician who can go over the risks and benefits of one drug over the other. These should always be taken under strict medical supervision least you fall prey to their habit forming potential or suffer side effects. Fortunately some of the newer drugs in development will better address some of these concerns and should provide better options in future.

 

Posted in Insomnia Tagged with: , , , , , , , , ,

February 24th, 2014 by sleepcureblog

scoring in sleep studies at sleepcuresolutions.com

  1. Is your sleep facility constantly over budget?
  2. Do you have a regular turnover of technologists?
  3. Do you have a backlog of patient sleep studies still needing to be scored?
  4. Does it take more than three business days to return scored results?

The answer lies in outsourcing your sleep scoring ( THE MYTH VS REALITY)

Myth: Outsourcing sleep scoring is cumbersome and technically difficult

Reality: It is fairly easy to set up and currently technology allows easy access and   flow of data

Myth:It’s uncommon for sleep labs/services to outsource

Reality: Its is a strongly emerging trend with more and more labs opting for this and currently 1in 4 sleep labs are outsource sleep scoring

Myth: Only big/small sleep labs/services need to outsource

Reality: This can work for any volume of work for different reasons and can potentially lead to major cost savings

Myth: Only expensive sleep scoring service can do a good job in scoring

Reality: As is with everything else in life more expensive do not always meansbetter; you may need to try it to believe it.

 Talk to Sleep Cure Solutions as to how we can help you with solutions that impact your bottomline (Prices starting from 25$ .Negotiable depending on volume)

 

Posted in SCORING Tagged with: , , , , ,

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