Sleep—an Essential Component of Obesity Screening and Counseling: A Policy Analysis of the Affordable Care Act

Abstract

The Patient Protection and Affordable Care Act (PPACA) has provided access to health care for millions of people in the United States. One of the most beneficial aspects of the PPACA is the obesity screening and counseling provision. Currently, it is estimated that over 39% of US adults are obese. Research has linked sleep disturbances to obesity and obesity-related behaviors. The purpose of this article is to advocate for evidence-based care through the inclusion of sleep disturbance screening and management under the PPACA obesity screening and counseling provision. An in-depth policy analysis of the PPACA was conducted to examine the feasibility of adding sleep screenings to the obesity screening and counseling provision available under current law. Findings suggest that the adoption of this policy would require stakeholder advocacy and educational reform. Implementation of the policy would require additional economic investments, but the long-term savings could be significant. A campaign to raise awareness regarding the association between sleep disturbance and obesity among the public and health care professionals would be essential. Policy implementation would require interprofessional collaboration when performing sleep disordered screening and management. Preventative health care for individuals who have not previously accessed the health care system has the potential to socially and economically benefit society if policies provide for evidence-based care. Sleep screening and counseling is essential under the PPACA to adequately address the US obesity crisis.

Sleep Health Characteristics among Adults Who Attempted Weight Loss in the Past Year: NHANES 2017–2018

“…Some researchers have suggested that sleep health should be considered an essential component of screening and counseling for weight management for several reasons [ 5 ]. First, sleep health characteristics including sleep duration, sleep timing, sleepiness and sleep regularity, are associated with weight gain and obesity independent of physical activity and diet [ 3 , 6 ].…”