Jun 20, 2022

Dr. Melissa Lim, Chief Medical Officer at Somnology Getting a good night’s sleep should have nothing to do with having a great health plan — but it often does. While some individuals can improve their sleep by making small changes, many who suffer from serious, chronic sleep disorders need a higher level of care and ongoing treatments, and many health plans offer insufficient benefits. For example, Medicare covers sleep diagnostic tests under strict conditions, if patients are referred by a physician . Other health plans have denied coverage altogether, such as this story about a man who was falling asleep behind the wheel who sought coverage for sleep apnea illustrates. Furthermore, incentives for tracking sleep are few and far between. In 2022, it’s time to wake up to the realities of our sleep-deprived society. An estimated 43% of the global workforce are not getting enough sleep. Up to 7% of adult men and 5% for adult women suffer from obstructive sleep apnea, and an estimated one-third of adults suffer from insomnia at some point in their lives, 10% persistently. These disorders are connected with a higher incidence of motor vehicle accidents , flare-ups of chronic diseases like diabetes and an increased risk of developing dementia . Why Health Plans Should Prioritize Sleep  Because sleep disorders tend to be chronic in nature, usually there isn’t a simple one-time “fix” — like taking a prescribed medication every day at the same time — that will cure someone. The same could be said of other conditions like diabetes. Healthy eating and exercise alone may not cure one’s diabetes, but most major health plans offer fitness and wellness incentives — including reduced monthly premiums for yoga classes or in-person/online weight-loss programs. Some health plans incorporate the use of third-party apps to encourage individuals to log in metrics, such as steps taken per day, and then offer rewards for active participation. A RAND Europe and Vitality Health study shows that these approaches can lead to improvements in activity levels by motivating individuals to maintain positive behaviors. Treating and preventing sleep disorders would not be merely a wellness perk — but rather a health imperative. Good quality sleep is just as important as fitness and nutrition in maintaining or improving overall individual health — especially for those with one or more chronic diseases. (And many athletes will tell you that sleep quality significantly impacts physical performance). Yet it’s practically unheard of for health plans to offer a 25% discount on a wearable watch or ring for the sole purpose of monitoring sleep. While some tech giants like Apple are partnering with payers like Aetna to incentivize use of fitness tracker apps ( Attain by Aetna ), sleep is not the primary focus of these programs. Moving Sleep to the Top of the Heap (of Priorities)  Although the process of improving sleep may be more difficult than sticking to an exercise routine, health plans that want to engage their members and boost sleep health should ensure they’re doing the following three things:  1. Spreading awareness. It’s possible many individuals with sleep disorders aren’t aware that they are suffering or that there are resources that can help them. That’s why health plans need to boost awareness of sleep disorders. Double up on Web content, such as blogs that offer tips for better sleep (e.g., shutting off screens, ensuring the bedroom is cool and dark, etc.). Also, they could make lists of sleep specialists covered by the plan easily accessible. 2. Encourage sleep tracking. Go beyond awareness-building by enabling patients to self-monitor their sleep health. For example: pairing rewards or incentives with the use of sleep trackers (or sleep logs) can motivate individuals to take stock of their health. For employers, implementing a corporate-wide sleep-apnea screening program for high-risk employees may be one way to directly engage individuals to monitor their sleep and be alerted to abnormalities. It should be noted here that too much tracking could make sleep problems, especially insomnia, worse, so while gaining insight into one’s sleep patterns using trackers is useful to most, a subset of hypervigilant people may do worse with tracking. This is another argument for professional, human interactions guiding the use healthcare tracking devices. 3. Adopt broader, more holistic sleep-health solutions. Some sleep solutions may be either inaccessible, insufficient, or both. The traditional, one-night sleep study at a sleep lab, or polysomnography, is the gold standard diagnostic test but is cumbersome, expensive, and artificial. Many individuals struggle to find the time to spend a night away from home. Wearable sleep trackers, while helpful for the monitoring sleep, fail to inform their users of the next steps, such as consulting with a doctor. Consider an alternative that marries these approaches, one that pairs the use of wearable sleep trackers with remote monitoring and telehealth. A growing number of enterprises are using this approach, enabling individuals to track sleep over several weeks, so biometric data is continuously transmitted to a remote sleep lab for analysis by a sleep specialist. After a detailed analysis, the patient can connect with the specialist over a virtual network for ongoing support. Going Forward By focusing more on helping their members sleep better, health plans will also see improved outcomes, cost savings and better member experience, which combine to offer downstream benefits, such as a boost in Star ratings or other quality metrics. As health plans continue to roll out fitness and wellness benefits to their members, they must also consider sleep health solutions that will inspire and incentivize members to engage. While rewarding wellness and exercise is a step in the right direction, health plans need to broaden their ideals of optimal health as they consider ways to reduce costs, improve outcomes and boost satisfaction. Dr. Melissa Lim, an internal medicine physician and sleep specialist, is the Chief Medical Officer of Somnology .