Sleep Apnea - Screening and Diagnosis

Diagnosis: key steps

Assessment

Recognise and identify common symptoms of obstructive sleep apnea (OSA).

Screening

Ask your patient to undergo a sleep apnea screening test by completing a symptom questionnaire or by using a home sleep screening device.

Diagnosis

Based on the results of the screening, recommend a sleep study for your patient to monitor and determine the severity of their OSA.

All about sleep studies

Sleep studies should be performed in the patient’s home or at a sleep clinic, in line with local rules and regulations.

During a sleep study, your patient’s breathing, body movements and responses during the night are monitored to see if them has a sleep disorder such as sleep apnea.

Below is some information you can pass on to your patients about what happens during a sleep study.

Sleep study in a clinic

In a clinic, hospital or sleep lab, clinical staff will place sensors on your patient’s body to monitor their sleep.

Sensors are placed:

On the chest to monitor heart activity;
Close to the eyelids to measure eye movements that help indicate if the patient is in REM or non-REM sleep;
On the head to measure electrical signals from the brain;
On the legs to assess muscle activity.

Patients will also be fitted with:

A nasal cannula to monitor breathing;
An oximeter on their finger to record oxygen levels;
Bands around their chest and stomach to measure breathing effort.

With your patient’s permission, staff may also ask to film the sleep study to gain more insights into the patient’s sleeping behaviour.

During this type of study, your patient will be required to stay overnight at the facility, so they should take everything needed for their usual sleeping routine, including pyjamas and toiletries.

What do sleep studies measure?

Among other things, the sleep study will indicate the severity of your patient’s condition, which is classified using the apnea/hypopnea index (AHI).

The AHI score indicates the number of apneas and hypopneas your patient has per hour (<5 to 30+).¹

Severity	AHI (per hour)
Normal	<5
Mild	5 to <15
Moderate	15 to <30
Severe	30+

In addition to the patient’s AHI, the diagnosis will take into account the patient’s oxygen desaturation and in case of OSA, excessive daytime sleepiness.

Once you receive your patient’s sleep study results, you can then talk to them about the condition (if it’s present), its severity, its possible health effects and  treatment options.

More about sleep-disordered breathing

Common symptoms of sleep apnea

The first sign of a sleep disorder is snoring, even though many patients won’t identify that as a sign of something more serious. There are other common symptoms too.

Types of sleep apnea

There are three types of sleep apnea: Obstructive Sleep Apnea (OSA), Central Sleep Apnea (CSA) and mixed or complex sleep apnea. Each type has distinctive characteristics that enable diagnosis.

Associated comorbidities

When left untreated, patients with SDB like OSA and CSA have an increased risk of developing serious chronic diseases such as cardiovascular disease, and type 2 diabetes. A significant number of patients with COPD also have SDB.

References

American Academy of Sleep Medicine, Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep, 1999. 22(5): p.667-89.

Screening and diagnosis