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.
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