To dream, perchance, of getting good sleep

Medicare makes it harder for seniors to get the sleep care they need

Thank you for Robert Weisman’s important article about sleep disorders in older patients (“An extra hour is no sleep solution,” Page A1, Nov. 1). As he notes, “up to 20 percent of those denied treatment by insurers should be eligible,” one study found, citing insurers’ “reliance on a metric established in the 1970s that doesn’t account for individual variation.” Let’s be more precise. In my opinion, the insurer that inappropriately interferes the most with the diagnosis and treatment of seniors with obstructive sleep apnea syndrome is Medicare.

Medicare’s metric uses a more restrictive bar than that used by most commercial insurers. This means that seniors, who are more likely to have cardiovascular problems that can be aggravated by untreated sleep apnea, are less likely to receive proper diagnosis and treatment than those who are younger than 65.

I am sick and tired of seeing affected seniors go untreated. For the sake of our seniors, Medicare should readjust its metric in line with that which is accepted by the American Academy of Sleep Medicine and by most of the American insurance industry.

Dr. Gary Stanton


The writer is a specialist in sleep medicine at Emerson Hospital.

Trouble with sleep? Consider what you eat


Searching for sleep solutions for seniors needs to go beyond probes, prescriptions, and supplements. My clients who are over 50 know that their nocturnal bathroom visits are dicey. They may or may not go back to sleep immediately.

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For some stress-induced insomniacs, diet can make a critical difference. One 72-year-old client eats a banana at 3 a.m. Another sleepless client eats an apple with peanut butter.

Treating disordered sleep requires a range of solutions. Nutritional approaches are life-changers for some, but only after a medical evaluation. Diabetes, heart disease, obesity, dementia, and cancer all have causal relationships to lack of sleep.

M. Susan Hamilton


The writer is a nutritionist.