For Ordering Physicians

Beaumont Sleep Evaluation Services provide sleep consultations and facility-based attended sleep tests for the patients with sleep disorders.

Download Beaumont Sleep Evaluation Services - Berkley Center order form

Download Beaumont Sleep Evaluation Services - Macomb Center order form

Ordering physicians can select one of the following services:

1. Facility-based attended sleep test only: the results of the test will be interpreted by a Board Certified sleep physician and sent to the ordering physician. No sleep physician consultation occurs. *See new Medicare & Insurance Documentation Rules Below*

2. Facility-based attended sleep test and Board Certified sleep physician consultation if the results of the test are positive for sleep disorder. The results of the test and sleep physician's interpretation with consultation notes will be sent to the ordering physician. *See new Medicare & Insurance Documentation Rules Below*

3. Board Certified sleep physician consultation including patient assessment and evaluation - facility-based attended sleep test will be performed if indicated. The sleep consultation notes will be sent to the ordering physician as well as the physician's interpretation with results of the performed test.

Beaumont Sleep Evaluation Services provide the following facility-based attended sleep tests:

• Polysomnogram (PSG)
• Positive Airway Pressure Titration
• Multiple Sleep Latency Test (MSLT)
• Maintenance of Wakefulness Test (MWT)

Polysomnogram (PSG)

A polysomnogram or PSG is a complex measure of EEG, of Respiratory parameters including flow, effort and oxygen saturation, of EMG and of EKG.

The EEG is used to measure sleep stages in correlation with breathing pattern, sleep disruptions, and parasomnias. Additional EEG leads are used to determine seizure activity.

Respiratory parameters include airflow, chest and abdomen effort, oxygen saturation and sometimes CO2 monitoring to diagnose sleep related breathing disorders. Apneas, hypopneas (partial apnea), hypoventilation and Cheyne-Stokes breathing can be diagnosed through these measures.

EMG is used to diagnose Sleep- related Movement Disorders including bruxism and Periodic Limb Movement Disorder.

Oxygen saturation and heart monitoring are used to show a possible correlation between decrease in oxygen saturation due to apneas and cardiac arrhythmias.

This is an overnight test in a hotel like room with a private bathroom. 

The patient will have electrodes and belts placed on them. 

A fully trained staff is on hand to make your patients' experience a pleasant one and to provide patients' education. 

Patient's normal bedtime can be accommodated.

Appointments are available 6-7 days a week. 

A timely interpretation and final report are sent to the ordering physician office. 

Positive Airway Pressure Titration

A CPAP/BPAP Titration is the treatment portion of your patients' study for Sleep related breathing disorders. 

The most common scenario is Obstructive Sleep Apnea (OSA). 

This test includes all the parameters of a PSG with the addition of a positive air pressure delivery device.

The pressure is adjusted throughout the night by our trained staff to control the patients' respiratory events, and optimize oxygen saturation and sleep efficiency.

A technologist will orientate the patient to the therapy and the devices.

A trial before the test begins will be performed.

There are several modalities and comfort adjustments that can be done to help patients who have difficulties breathing with the pressure.

Multiple Sleep Latency Test (MSLT)

A Multiple sleep latency test (MSLT) is a test to confirm, or rule out the presence of Narcolepsy. This is a series of 5 naps at certain intervals throughout the daytime following a Polysomnogram (PSG).

The PSG is performed to monitor the efficiency and quality of sleep preceding this procedure. 

The 5 naps are performed throughout the day at 2 hours intervals. The naps generally last between 20-35 minutes. The sleep latency and REM onset are measured for all 5 nap. 

A blood/urine test for stimulants may be necessary. 

Patients are made as comfortable as possible with juice, snacks, and subscription television in every room. Sitting rooms are also available. Patients are encouraged to bring their own meals (especially for special diets) but simple meals can be provided. 

Maintenance of Wakefulness Test (MWT)

A Maintenance of Wakefulness test (MWT) is a test performed to measure patient's ability to stay awake and consists of four sessions of forty minutes each recorded throughout the day.

PSG test is not necessary before the MWT.

During MWT sessions, the patient is to sit comfortably in a dimly lit room. The patient cannot have any outside stimulus (television, music, reading). The patient should be able to stay awake during the test.

A blood/urine test for stimulants may be necessary. 

Again, the patients are encouraged to bring their own meals (especially for special diets) but simple meals can be provided.  

New Medicare & Private Insurance documentation for the Sleep Study and CPAP 

They won't cover the cost of the polysomnogram or CPAP for your patient unless you do the following BEFORE the polysomnogram:

1. You document a face-to-face visit with your patient

2. Your office notes from that visit document the following:

   a. Sleep history and symptoms including, but not limited to:

• Snoring
• Observed apneas
• Choking or gasping during sleep
• Daytime sleepiness
• Morning headaches

   b. Epworth Sleepiness Scale score (copy on our website), and

   c. Physical examination that documents:

• Body mass index
• Focused upper airway exams
• Neck circumference
• Focused cardiopulmonary exam