Sleep medicine: Examinations for sleep apnea are now also possible with non-specialist internists
02.06.2022 10:25
Sleep apnea is one of the most common sleep disorders in Germany. According to figures from the Federal Statistical Office, more than 90,000 people are examined for this reason every year. In order to determine whether someone is suffering from pauses in breathing during sleep, doctors analyze the sleep behavior of those affected as part of a so-called polygraphy. This examination can be carried out on an outpatient basis using a mobile measuring device. Since April 1, 2022, internists without a specialty can also receive permission to carry out this examination. At the instigation of the German Society for Internal Medicine e. V. (DGIM), the National Association of Statutory Health Insurance Physicians (KBV) has adapted the corresponding quality assurance agreement.
Anatomical peculiarities in the throat and airways, as well as obesity or alcohol consumption can cause sleep apnea. Doctors use polygraphy to determine the exact cause of the sleep disorder. To do this, the treating person places probes on the affected person's chest and gives them a measuring device to take home, which measures, among other things, body position, breathing air flow, chest and abdominal movements and the oxygen saturation of the blood during the night. This outpatient examination is very comfortable for patients because it is carried out at home in the comfort of their own home. “Sleep apnea promotes heart disease and heart patients with sleep apnea have a less favorable course of the disease,” explains Professor Dr. medical Georg Ertl, Secretary General of the DGIM and cardiologist from Würzburg.
Since April 1, 2022, internists without a specialty can also receive approval to bill for polygraphs. The prerequisite for this is successful participation in a 30-hour course. In it, the doctors renew their specialist knowledge of sleep-related breathing disorders and how to use the polygraphy examination method. Doctors receive approval to bill for treatment upon application from their association of statutory health insurance physicians.
Sleep medicine is part of the training
The basis for the innovation is that the KBV updated the corresponding quality assurance agreement at the instigation of the DGIM. The agreement originally stipulated that in addition to general practitioners and internists specializing in cardiology and pulmonology, “specialists in internal medicine and general medicine” were also allowed to carry out polygraphy. “This specialist title had to be deleted in 2007 for European law reasons. However, when the quality assurance agreement was revised at the time, the specialist in internal medicine without a focus was not included,” explains DGIM managing director RA Maximilian Broglie. Since 2018, the model training regulations for specialists in internal medicine have also included sleep medicine content. “We as DGIM have worked hard to ensure that the legal framework for polygraphy billing is adapted to the current status of further training in internal medicine, and we are pleased that this has now been achieved,” says Broglie.
Additional Information:
Quality assurance agreement in accordance with Section 135 Paragraph 2 SGB V for the diagnosis and therapy of sleep-related breathing disorders from April 1st, 2005 in the version valid from April 1st, 2022: https://www.kbv.de/media/sp/Schlafbezogene_Atmungsst_rungen.pdf