Over 104 million Indian adults suffer from Obstructive Sleep Apnea (OSA), but insurance companies deny coverage. Experts advocate for standardized insurance coverage for sleep disorders, citing life-threatening complications and financial burdens on patients.
KOLKATA, WEST BENGAL: Somnath Maity is the Director of the , a government-authorized sleep laboratory that diagnoses and treats sleep disorders with a team of doctors. As a trained myofunctional therapist who has been working with patients suffering from Obstructive Sleep Apnea (OSA) for the last 30 years, Maity is keenly aware of the dangers of leaving a sleep respiratory disorder untreated for long.
More than 104 million Indian adults suffer from Obstructive Sleep Apnea, a breathing disorder that interrupts the flow of oxygen while patients sleep. OSA is one of the most common forms of sleep disorders in the world, often progressing to more critical complications over time like heart attacks and brain strokes.
Treatments for sleep apnea require CPAP — a type of medical device that forces air through the windpipe as patients sleep. It may also require surgeries in some cases.
While these treatments are medically approved and have been around since the 1980s, all major insurance companies include them as a categorical exclusion in India. This includes both private insurers (HDFC Ergo, Star Health, ICICI Lombard, etc.) and public insurers (New India Assurance, National Insurance, etc.).
Patients are refused any treatment for sleep-related illnesses like OSA. In some cases, they may even be denied a policy altogether if they mention having such disorders.
But why deny claims related to sleep disorders? Somnath Maity, Director of the Institute of Sleep Science in Kolkata, says it makes no sense. “The same insurance companies are paying upwards of 5 to 10 lakh INR when these patients enter the emergency room due to heart failure. This could have been avoided if they had paid 1/10th of the amount for basic sleep apnea treatment when the patient was first diagnosed.”
For the last several years, India라이브 바카라 medical community has been repeatedly advocating for sleep disorders to be brought into the fold of medical insurance. But insurance providers have remained silent.
Sharmila Bhattacharya, a biology teacher at Modern High School for Girls, contacted Maity after her husband Ayan was diagnosed with sleep apnea about six years ago.
“My husband was developing other health complications due to his sleep apnea,” said Bhattacharya. “There were many times when he dropped unconscious on the road due to low oxygen in his blood. It could have easily led to an accident.”
This is not uncommon. In fact, a study conducted by the American Academy of Sleep Medicine found that sleep apnea patients were 2.5 times more likely to be in a road accident than most people.
Sharmila라이브 바카라 family was covered by two separate insurance policies at the time of the incident. One was a family health insurance policy from New India Assurance. The other was a group health policy arranged by Ayan라이브 바카라 office. Both of them refused to cover any sleep apnea treatment, providing no further explanation as to why.
Eventually, the family had to pay for the CPAP device out of their own pockets. But since using the device, Ayan has had no further problems and his blood oxygen levels are always normal.
They aren’t alone. Jayanta Jana, who works as an insurance agent, said that his claims were denied by New India Assurance when he was recommended for a CPAP device a few years ago. “My doctor said that if I didn’t use a CPAP machine, I could have a stroke any day in my sleep.” He was told that he might also require surgical treatment along with the CPAP device.
Not surprisingly, Jana라이브 바카라 insurance claim was also denied without explanation. He says he barely has the means to buy a CPAP device, let alone do that and pay for his surgery too.
Claim denials aren’t limited to CPAP devices. Nabagopal Biswas said that when he was diagnosed with sleep apnea, his doctor suggested that he go for surgery to remove his nasal polyp. Biswas went through the operation thinking that he was covered by his health insurance policy with IFFCO-Tokio. However, right when the hospital raised a cashless claim against his medical bills, his claim was denied.
Unfortunately, this is not about a single insurance company. A closer inspection reveals that among the 28 insurance providers listed on the IRDAI라이브 바카라 website, every single one of them includes sleep disorders as a permanent exclusion for all their health plans.
Why? While insurance companies stay silent, doctors say they are confused. “It라이브 바카라 not like cosmetic surgery,” said Dr. Dipankar Datta, an ENT surgeon who serves as the regional head of the Indian Association of Surgeons for Sleep Apnea. “OSA is a life-threatening disorder that can lead to heart failure, stroke, diabetes, blood pressure, asthma, dementia, and even car accidents.”
Datta has been collaborating with Somnath Maity at the Institute of Sleep Science. Together, they have been trying to bring this to the attention of insurance providers since 2019.
They first expressed their concerns a few years back during a conference on sleep apnea at the Biswa Bangla Convention Centre. Many delegates from insurance companies attended the discussion. However, there has been no decisive action from the companies since.
Maity said there라이브 바카라 no real reason to deny claims related to sleep disorders. If insurance companies are worried about fraud, they can set forth clear criteria to assess sleep-related claims. “But why deny access to life-saving treatment when doctors agree that it라이브 바카라 necessary?”
Of course, treatment is only possible once the condition is discovered in the patient. But a diagnosis of sleep apnea requires multiple tests, including an overnight polysomnography and a sleep endoscopy. Without them, doctors can’t plan the right course of treatment. Sadly, they are expensive because each test requires staying at the hospital for a day at a time.
“Financial barriers discourage patients from undergoing tests, since those aren’t covered under their insurance plans either,” said Dr. Pallab Chatterjee, a pediatric pulmonologist who treats children with OSA. “Despite clear signs, the condition never gets diagnosed, let alone treated.”
These tests are nothing out of the ordinary, explained Datta. The first step is to conduct a polysomnography, which is also called a sleep study. It involves using a machine to monitor the patient라이브 바카라 blood oxygen as they sleep. If the report comes back positive, doctors perform a nasal endoscopy under anesthesia to see exactly where the obstruction lies.
Patients have to be hospitalized, because the tests can only be performed in a controlled environment with medical-grade equipment while they sleep, added Chatterjee. This is not possible at home.
Generally, insurance providers always reimburse patients for diagnostic tests that require a hospital stay of at least one night. Not in the case of sleep disorders. With an overnight polysomnography costing in the ballpark of Rs. 8,000-10,000 and a DISE (drug-induced sleep endoscopy) costing as much as Rs. 20,000, this is something that makes many patients hesitate.
Dr. Arup Das Biswas, Former Director of Cardiology at IPGMER and SSKM Hospital, explained how untreated sleep apnea can lead to long-term heart disease in two different ways.
“First, it cuts off the body라이브 바카라 oxygen supply, causing hypoxia,” he said. That leads to surges in blood pressure and heart rate. Over time, this can reduce cardiac function and lead to complications like hypertension, left ventricular hypertrophy, and atherosclerosis.
“But then, there are also a number of indirect causes,” he continued. OSA is often associated with obesity, insulin resistance, daytime sleepiness, etc. All of these risk factors eventually contribute to heart disease, leading to incidences of cardiac arrest and heart failure.
Of course, sleep apnea라이브 바카라 long-term effects aren’t limited to the heart. Hypoxia reduces the flow of oxygen to all parts of the body, including the brain. This leads to neurological complications, such as dementia, brain fog, cognitive impairment, and even cerebral strokes.
Similarly, complications of the respiratory system, liver, kidneys, and blood vessels are all quite common. When patients already have other comorbidities, OSA can make things much worse.
But the lack of sleep apnea coverage isn’t just affecting those with health insurance. It라이브 바카라 also halting the progress of India라이브 바카라 healthcare infrastructure as a whole.
Inspire Sleep is a new FDA-approved medical implant that라이브 바카라 showing remarkable results in patients with sleep apnea. If a patient continues to have issues after using CPAP, getting the implant can enable them to lead normal lives without relying on an external device. It라이브 바카라 already being used by more than 50,000 people across the US and EU.
Getting the implant doesn’t even require surgery, it can be attached to the body using a non-invasive procedure that takes just a few hours to complete. Once implanted, the device stimulates the nerves at the base of your tongue to keep the upper airway open while you sleep.
While the treatment is expensive, it라이브 바카라 covered under most insurance plans in the US and many in Europe. It has been a lifeline for patients with the most severe form of sleep apnea, who often don’t respond to other forms of treatment like devices or surgeries. Now, it is also being developed by other companies like Nyxoah from Belgium, who are trying to build more cost-effective solutions to improve accessibility.
But none of these solutions have entered the Indian market, explained Maity. Since they are not covered by insurance providers in the country, they don’t want to invest in entering a foreign market without a clear path to profitability.
“They simply don’t see the Indian market as profitable,” Maity said. “Even the people who could have paid for the treatment out of pocket now don’t have access to it.”
It라이브 바카라 not an easy road to getting standardized insurance coverage for sleep disorders across India. Experts say that it would require the involvement and cooperation of policymakers, healthcare professionals, and insurance providers alike. But it라이브 바카라 nothing that hasn’t been done before.
In 2023, the Insurance Regulatory and Development Authority of India (IRDAI) introduced guidelines that asked Indian insurers to offer standardized coverage for mental disorders across all their plans.
Before that, the stigma surrounding mental illness had caused those suffering from long-term psychiatric disorders to not have access to any insurance coverage at all.
Thanks to the guidelines from IRDAI, HDFC Ergo, Magma HDI, ICICI Lombard, Aditya Birla Capital, and Plunes HealthCare have all begun to offer cashless facilities for the treatment of mental health disorders at approved institutions. Government-sponsored schemes like Ayushman Bharat also offer coverage.
Now, healthcare professionals are hoping for a similar initiative for sleep disorders. “It라이브 바카라 hard to think that standardized care would be possible without some change at the policy level,” said Maity.
Once the IRDAI clarifies its position, he believes that insurance companies will begin to pay attention. While it may be some time before new plans get implemented, at least there will be some hope for sleep apnea patients to get the quality care they need.
is the first Level 1 Sleep Laboratory in Eastern India that라이브 바카라 licensed to perform a polysomnography test for diagnosing sleep apnea patients. They also have a team of medical professionals who can advise and treat patients suffering from Obstructive Sleep Apnea, a respiratory disorder that causes breathing trouble during sleep.