Management of obstructive sleep apnea in the indigent population: A deviation of standard of care?

John S. Hamblin, Vlad C. Sandulache, Philip M. Alapat, Masayoshi Takashima

Research output: Contribution to journalReview articlepeer-review


Comprehensive management of patients with obstructive sleep apnea (OSA) typically is managed best via a multidisciplinary approach, involving otolaryngologists, sleep psychologists/psychiatrists, pulmonologists, neurologists, oral surgeons, and sleep trained dentists. By utilizing these resources, one could fashion a treatment individualized to the patient, giving rise to the holistic phrase of "personalized medicine." Unfortunately, in situations and environments with limited resources, the treatment options in an otolaryngologist's armamentarium are restricted - typically to continuous positive airway pressure (CPAP) versus sleep surgery. However, a recent patient encounter highlighted here shows how a hospital's reimbursement policy effectively dictated a patient's medical management to sleep surgery. This occurred although the current gold standard for the initial treatment of OSA is CPAP. Changing the course of medical/surgical management by selectively restricting funding is a cause of concern, especially when it promotes patients to choose a treatment option that is not considered the current standard of care.

Original languageEnglish (US)
Pages (from-to)346-347
Number of pages2
JournalOtolaryngology - Head and Neck Surgery (United States)
Issue number3
StatePublished - Mar 2014


  • CPAP
  • indigent
  • low-income
  • obstructive sleep apnea
  • uvulopalatopharyngoplasty

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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