Australian Government - Department of Health and Ageing

Medical Services Advisory Committee (MSAC)

Application 1130 Home Based (unattended) Sleep Studies

Unattended Sleep Studies in the Diagnosis of Obstructive Sleep Apnoea

Application No.

1130

Application Name Unattended Sleep Studies in the Diagnosis of Obstructive Sleep Apnoea
Advisory PanelProfessor Ken Thomson
(Chair)
(MSAC Member)
Dr Kwun Fong
(Deputy Chair)
(MSAC Member)
Mr Gary Carr
(Consumers' Health Forum of Australia nominee)
Dr John Malouf
(Ear Nose and Throat Specialist)
Clinical Professor Dominic Fitzgerald
(Royal Australasian College of Physicians, Paediatric)
Professor Matthew Naughton
(Royal Australasian College of Physicians)
Head of the General Respiratory and Sleep Medicine Service)
Professor Donald Campbell
(Monash Medical, General Physician/ Epidemiologist)
Dr Walid Jammal
(Royal Australasian College of General Practioners)
Date Received by MSAC Secretariat17 September 2008
Stage 1 - EligibilityEligible
Stage 2 - AssessmentCompleted
Stage 3 - Formulation of Advice to the MinisterAfter considering the strength of the available evidence in relation to safety, effectiveness and cost-effectiveness, MSAC supports public funding for the use of Level 2 unattended sleep studies for investigation of obstructive sleep apnoea (OSA) for a duration of at least 8 hours, for an adult aged 18 years and over, where:

(a) the patient is referred for the investigation by a medical practitioner who has formed a reasonable clinical view that the patient has a high probability of having OSA

*[(b) the necessity for the investigation is determined by a qualified sleep medicine practitioner (as defined in the explanatory notes to the MBS) prior to the investigation;] [*referred study]

(c) a qualified sleep medicine practitioner has:

(i) established quality assurance procedures for the data acquisition; and
(ii) personally analysed the data and written the report;

(d) during a period of sleep, the investigation is a recording of a minimum of seven channels which must include continuous EEG, continuous ECG, airflow, thoraco-abdominal movement , oxygen saturation; and two or more of EOG, chin EMG and body position.

(e) interpretation and report of the investigation (with analysis of sleep stage, arousals, respiratory events and assessment of clinically significant alterations in heart rate) are provided by a qualified sleep medicine practitioner based on reviewing the parameters recorded under (d) above.

MSAC supports the payment of the benefit only once in a 12-month period, and recommends review of the Schedule Fee for Level 2 unattended studies in the current interim MBS item 12250 to ensure that the service remains cost-effective.

MSAC does not support public funding for Level 3 or 4 unattended sleep studies.

MSAC does not support public funding for any unattended sleep studies for diagnosis in a paediatric setting or for reassessment of treatment efficacy.

Stage 4 - Decision
Noting of MSAC advice by the Minister does not constitute a final decision in relation to the provision of public funding
MSAC considered this assessment on 29 March 2010
The Minister noted MSAC's advice 2 June 2010
Stage 5 - ImplementationIn Progress