Telehealth Isn't a Luxury — It's a Necessity
Hello, and thank you for joining me today. I'm Dr Alison Kole. I'm boarded in pulmonary critical care and sleep medicine, and I have been practicing for over a decade. I also am the creator and host of the Sleep is My Waking Passion podcast and the medical director of the Oak Health Center Concierge Sleep Telemedicine Program.
Today I want to speak directly to you about a critical issue that's occurring in sleep medicine, which is the future of telehealth. There's a lot at stake, and decisions made now will impact patient care for years to come.
Some of you may not be aware, but the American Academy of Sleep Medicine [AASM] issued a position statement in February of 2025, urging for the consideration of permanent telehealth services.
During the COVID-19 pandemic, emergency waivers allowed for widespread use of telehealth, including coverage for both video- and audio-only visits. This expansion was a lifeline for both patients and providers, and was able to ensure that care continued despite unprecedented times. However, these were temporary waivers and the waivers are set to expire. So, there is a real danger that coverage and reimbursement for telehealth, especially in sleep medicine, could be rolled back.
You can think of the AASM's position statement as a call to action. Without permanent coverage in adequate reimbursement, millions could lose access to essential sleep care. And this isn't just a theoretical concern. If telehealth goes away, access will be cut off for many who cannot easily reach in-person services due to a variety of reasons, including geography, mobility, work, or technology barriers.
So, why is it that sleep telemedicine is so especially suited to telehealth? There are several reasons for your consideration. Perhaps one of the most obvious reasons is that in order to diagnose sleep disorders, many of us can usually do that without much of a physical exam. Most of our assessments are dependent upon history, sleep diaries, and sleep study data. It's not necessarily a hands-on exam, so this makes remote care both practical and effective in sleep.
There's also a couple of other reasons, including our ability to do remote patient monitoring. Most of our CPAP devices allow us to be able to track and see if a patient is being compliant with therapy, but also are they getting effective therapy so that we can triage and make adjustments remotely without the patient needing to come into the office for that.
And last but not least, 12% of Americans are living with chronic insomnia in this country. The number-one recommended treatment is cognitive-behavioral therapy for insomnia. This is a series of visits to a behavioral health specialist that can be time-consuming, and there is data that demonstrate that digital cognitive-behavioral therapy for insomnia platforms performs almost equivocally to that of in-person visits.
There are several benefits to sleep telehealth access, and these include access, equity, safety, and cost. So, let's get into it.
Expanded access: What do I mean? Well, telehealth bridges gaps for rural patients, those with mobility challenges, and people who live far from specialty centers. It also allows sleep specialists, such as myself, to serve patients across state lines.
With regard to health equity, audio-only telehealth happens to be crucial for patients without reliable internet or smart devices. Cutting this option would disproportionately harm lower-income, elderly, and rural populations.
There's also a patient and public safety issue worth considering. Many sleep patients happen to be at higher risk for drowsy driving. Telehealth eliminates the need for these patients to travel, which directly reduces accident risk. This protects not only the patient but also the public.
And lastly, there is an economic value to sleep telemedicine services because treating sleep disorders like obstructive sleep apnea saves the healthcare system billions by preventing complications related to chronic comorbid conditions. These include hypertension, heart disease, and diabetes. Telehealth adds further savings by reducing travel time off from work and no-show rates.
If telehealth goes away, you're looking at a loss of access, worsening health disparities, reduced public safety and patient safety, as well as higher costs of care for patients. Telemedicine is not a luxury; it's a necessity for modern, equitable, and effective care. As primary care providers, you play a crucial role in advocating for and utilizing these services to ensure your patients get the care they need when and where they need it.
If you'd like to check out the completed episode with my interview featuring Dr K. Praveen Vohra, the lead author of the AASM position statement, please check out my YouTube channel, youtube.com/@asktheSleepMD.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
New York Post
3 hours ago
- New York Post
New tool can remove nearly all of a cancer-causing ‘forever chemical' from water — in just 5 minutes
Your tap water's dirty little secret might have just met its match. Scientists have engineered a high-tech filter that strips toxic 'forever chemicals' from drinking water in a matter of minutes. Better yet, the new tool glows on contact with contamination, serving as both a purifier and an real-time monitoring system. 4 Research suggests the majority of Americans have 'forever chemicals' in their drinking water. sebra – Forever chemicals — officially known as per- and poly-fluoroalkyl substances (PFAS) — are tiny, man-made compounds that break down very slowly and accumulate in people, animals and the environment over time. They've been used since the 1940s in everything from non-stick cookware and grease-resistant food packaging to waterproof fabrics and personal care products. But concerns are mounting over the potential health effects of PFAS, with some experts likening them to 'slow poison.' One of the most widely used forever chemicals, perfluorooctanoic acid (PFOA), has been linked to higher risks of certain cancers, liver damage, immune system issues, high cholesterol and even developmental delays in fetuses and children. It has been detected across a range of environments and products — from soil and rainfall to seafood, human blood and drinking water. 4 While PFOA was previously used in the manufacturing of non-stock cookware, it has largely been phased out due to concerns about potential health and environmental risks. Dina – In fact, a 2020 study estimated that more than 200 million Americans are drinking water contaminated with PFOA or PFOS, another notorious forever chemical formally known as perfluorooctane sulfonate. Now, researchers at the University of Utah may have found a way to help reduce that exposure. The scientists recently developed a lab-engineered, crystalline substance known as a metal-organic framework (MOF) that functions like a molecular sieve. When water flows through the material, it snags and traps PFOA molecules, effectively removing the forever chemical. 4 The work builds on past research from the team that created a porous material that fluoresces in the presence of PFAS. THE UNIVERSITY OF UTAH In lab tests, the MOF cleared out more than 99% of the toxic substance in just five minutes. 'This sort of rapid treatment is crucial for real-world applications,' the study authors wrote in their report. The material also worked in the presence of other PFAS compounds, salts, and natural organic matter found in drinking water supplies, suggesting it could perform well in a variety of real-world environmental conditions. Better yet, the MOF can be reused, with researchers finding it retained 93% of its adsorption efficiency after five wash cycles. That's a big deal, since current methods for removing PFAS are often slow, costly, inefficient and don't hold up well after repeated use. 4 PFAS in drinking water are estimated to contribute to more than 6,800 cancer cases each year. WESTOCK – An added bonus: when PFOA molecules bind to the material, it glows fluorescent — providing instant, on-the-spot confirmation of contamination. 'This MOF represents a major leap forward for PFAS remediation,' Rana Dalapati, the study's lead author, said in a statement. 'Its ability to both selectively capture and sensitively detect PFOA in real time makes it a versatile and practical solution for water treatment and environmental monitoring,' she added. Looking ahead, the team believes this material could one day be adapted to capture other PFAS chemicals, not just PFOA. Wondering if you should be concerned about forever chemicals in your drinking water? The Environmental Working Group's Tap Water Database is a good place to start — just enter your ZIP code to see what's in your local supply. While the newly developed MOF may one day offer a powerful solution, it will likely be a while before it's available for public use. In the meantime, if you live in an area with known PFAS contamination, consider getting a water filter. Look for one certified by the National Sanitation Foundation to reduce levels of PFOA and PFOS to help limit your exposure.
CNBC
3 hours ago
- CNBC
Are 2 to 3 cups of coffee a day too much? It's complicated, experts say: 'It's different for each person'
Two-thirds of Americans drink coffee every single day, according to data collected by the National Coffee Association in 2022, and the debate about how much is too much and whether or not any amount of caffeine is safe persists. But recent research shows that the answer is more complicated than you'd think. A Harvard study, that followed nearly 50,000 women over the course of 30 years and published in June, found that drinking coffee every day may lead to healthy aging in women. One to three cups a day was also linked to heart health benefits and lower mortality rates. But research also shows that high coffee consumption can increase your likelihood of dementia. And a 2022 paper published in the Journal of the American Heart Association found a link between heavy coffee consumption and an increased risk of dying from cardiovascular disease in people with hypertension. Benefits, drawbacks, and the right amount all depend on your individual lifestyle and overall health. And health experts consistently advise that, like with most things, moderation is key for your daily coffee. Deepak Chopra, author, speaker and proponent of alternative medicine, told CNBC Make It in 2023 that he drinks two to three cups of coffee each day before noon. While that may sound like too much caffeine for the average person, it's actually within a healthy range. "Drinking two to three cups before noon is safe to do," registered dietitian Roxana Ehsani said in an interview with CNBC Make It last year. "As long as they don't greatly surpass 400 milligrams of caffeine." Ehsani's suggestion follows the Food and Drug Administration's recommendation of consuming no more than 400 milligrams of caffeine a day, which can include the caffeine found in teas, energy drinks, sodas and chocolate. Certain people may benefit from consuming much less caffeine than is recommended by the FDA. Caffeine tolerance varies from person to person, with some people feeling anxious or jittery after just one or two cups of coffee. "Within those milligram or cup of coffee recommendations, if you start feeling overly tired and the caffeine is not helping, then you've got to stop [drinking it]," dietitian Jessica Sylvester told NBC News. "If your heart starts beating incredibly fast, you've got to stop. It's different for each person." Pregnant people should consider cutting back on caffeine. And people who have diabetes or cardiovascular disease should be mindful of their sugar intake when having coffee, Nikki Cota, a dietitian at the Mayo Clinic, told NBC News. Expert opinion also varies on if teens should drink coffee, but "avoiding caffeine is the best choice for all kids," according to the American Academy of Pediatrics. But for everyone else, if you're having two to three cups, or more, "be mindful of what you're experiencing," registered dietitian Maddie Pasquariello says. And make sure you're not replacing meals with caffeine. Ehsani recommends drinking water or having a meal before reaching for coffee since caffeine suppresses appetite. And if you notice your sleep is affected when you have a coffee in the afternoon, experts suggest a mornings-only rule for your daily latte or macchiato.
San Francisco Chronicle
4 hours ago
- San Francisco Chronicle
David Nabarro, British physician who led UN response to Ebola and COVID-19, dies
GENEVA (AP) — Dr. David Nabarro, a British physician who led the U.N. response to some of the biggest health crises in recent years, including bird flu, Ebola and the coronavirus pandemic, has died. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, confirmed Nabarro's death on social media platform X. 'David was a great champion of global health and health equity, and a wise, generous mentor to countless individuals,' Tedros wrote Saturday. 'His work touched and impacted so many lives across the world.' King Charles knighted Nabarro in 2023 for his contributions to global health after he served as one of six special envoys to the WHO on COVID-19. He won the 2018 World Food Prize for his work on health and hunger issues. He also was a candidate for the top job at the WHO in 2017 but lost out to Tedros in the final round of voting. Nabarro left the U.N. later that year. The 4SD Foundation, a social enterprise in Switzerland focused on mentoring the next generation of leaders in global sustainable development, said its strategic director died at his home Friday in a 'sudden passing.' Other details were not immediately available. 'David's generosity and unwavering commitment to improve the lives of others will be sorely missed,' the foundation wrote on its website Saturday.
