Live Recordings (Business of Sleep Medicine 2026)-02 Expanding Your Sleep Teams impact with APP

Video Transcription

Video Summary

The speaker reviews worsening shortages in the sleep physician workforce and argues that advanced practice providers (APPs—nurse practitioners and physician assistants) are essential to maintain and expand access to high-quality sleep care. Despite growth in matched sleep fellows, estimates of practicing sleep physicians have fallen (about 7,500 in 2014 to 5,700 in 2024), with many near retirement and rising patient complexity (narcolepsy, medication management, hypoglossal nerve stimulation, obesity pharmacotherapy) plus increasing administrative burdens like prior authorizations.<br /><br />Using the Triple Aim (better experience, population health, lower cost), the speaker notes APPs cost less per RVU than physicians and are increasingly used (61% of practices in 2018 vs 72% in 2024). Two main strategies are presented: train APPs as sleep generalists to expand capacity and reduce wait times, or develop APP-run specialty clinics (PAP follow-up, Inspire/Genio, insomnia/CBT-I, obesity/incretin therapy).<br /><br />Because most APPs have minimal sleep training, the talk proposes a “mini-fellowship” onboarding model: 4–6 weeks shadowing, completing AASM ASTEP APP modules, targeted readings, and progressive independence with ongoing supervision. Team-based “hub-and-spoke” care is emphasized for quality, retention, and work-life balance, along with productivity-based compensation and professional development. Audience discussion highlights the importance of physician support, marketing APPs to referrers, training checklists/metrics, and break-even volume targets.

Keywords

sleep physician workforce shortage

advanced practice providers in sleep medicine

APP mini-fellowship onboarding (ASTEP)

team-based hub-and-spoke sleep care

PAP follow-up specialty clinic

hypoglossal nerve stimulation (Inspire/Genio) clinic

insomnia CBT-I and obesity incretin therapy management