AHRQ report is ‘call to action’

DARIEN, Ill. – A recent draft report from the Agency for Healthcare Research and Quality that says studies mostly do not support long-term benefits of CPAP therapy on cardiovascular and other health outcomes has sleep professionals “up in arms,” says Dr. Susheel Patil, chair of the American Academy of Sleep Medicine.  

“The sleep community is not clear on what the motivation for the report is,” he says. “I think the question becomes whether the AHRQ realizes the implications of what the report might do in terms of other stakeholders that are less nuanced about science.” 

The AASM spearheaded comments to the report from a coalition of organizations, including the American Thoracic Society, the American Association for Respiratory Care and the Sleep Research Society. 

Patil spoke with HME News recently about the possible repercussions of the report on policy by government and commercials payers. 

HME News: What’s your general take on the AHRQ draft report? 

Dr. Susheel Patil: It sounds as if the report is suggesting that there is no benefit whatsoever for obstructive sleep apnea or that the evidence is weak. However, I don’t know if that was the intent. The strong concern is the almost complete absence of acknowledgement of the effectiveness in treating OSA with CPAP to improve excessive sleepiness, which is a significant long-term outcome valued by patients and providers. While the evidence may not be there for cardiovascular events, for sleepiness, that message needs to come through.  

HME: Are you concerned that a report like this could have a detrimental effect on sleep policy? 

Patil: I think (it’s a concern) how this might influence third-party payers and government payers that are setting policies. They could revisit the national coverage determination for sleep apnea, for instance. But I’m an optimist. There have been other reports that have come through and no actions have resulted. 

HME: Do you feel the AHRQ raises any good points in the report? 

Patil: I take their point to heart in the sense that the sleep community, in terms of research, still has a lot to do to establish key relationships between treating OSA and preventing cardiovascular events, and this is a call to action to the community and to government funding agencies to help us do this by funding (research). 

HME: In the comments, you state that the AHRQ makes a case for future research on the long-term benefit of CPAP therapy but that the recommendations are incomplete. Can you explain? 

Patil: It’s helpful they thought about the future direction of research but there could have been greater specificity in terms of what the roadmap to that looks like. Having a partnership with the sleep research community would be beneficial.