Materiały źródłowe

• #1 Obstructive Sleep Apnea Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6140019/

  The diagnosis and treatment of obstructive sleep apnea is discussed in the context of recent diagnostic and therapeutic advances. […] Obstructive sleep apnea (OSA) is characterized by episodes of breathing cessation or shallow breathing in sleep. […] According to a recent report by American Academy of Sleep Medicine (AASM), OSA affects 12% of US adult population totaling 29.4 million individuals and 80% of these are undiagnosed. […] The annual economic burden due to the undiagnosed sleep apnea is estimated around $150 billion in year 2015. […] Modified from International Classification of Sleep Disorders Third edition (ICSD-3) satisfies the criteria: The presence of one or more of the following: The patient complains of sleepiness, nonrestorative sleep, fatigue, or insomnia. […] Polysomnography (PSG) or out-of-center sleep testing (OCST) demonstrates five or more predominantly obstructive respiratory events (obstructive apneas, hypopneas, or respiratory effort related arousals [RERAs]) per hour of sleep during a PSG or per hour of monitoring (OCST).

• #2 Sleep Apnea | Symptoms & Treatment Options | IU Health

  https://iuhealth.org/find-medical-services/sleep-apnea

  Sleep apnea entails stopping breathing for short periods of time while you sleep. This common condition may seriously impact your health by increasing your risk for heart disease, stroke and diabetes, among other conditions. […] Our physicians provide expertise in treating sleep apnea to improve your health and quality of sleep. […] Common signs and symptoms of sleep apnea include: Snoring, Waking up gasping/choking for air, Obesity, Large neck, Increased work of breathing at night, Excessive daytime sleepiness, Restless sleep, Dry throat/mouth when waking, Memory loss, Morning headaches, Frequent urination at night, Lack of concentration. […] If you have daytime sleepiness or snoring, talk to your physician about the possibility of sleep apnea. […] During an overnight sleep study at an IU Health Sleep Disorders Center, our board-certified physicians and registered technologists observe sleep patterns, provide skilled diagnostic services, and treatment options for each patient. […] For some, you will complete sleep studies at home in the comfort of your own bedroom. You will simply pick up sleep monitoring equipment from an IU Health Sleep Disorders facility and return it when finished.

• #3 Sleep apnea – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/sleep-apnea/diagnosis-treatment/drc-20377636

  Your health care provider may make an evaluation based on your symptoms and a sleep history, which you can provide with help from someone who shares your bed or your household, if possible. […] You’re likely to be referred to a sleep disorder center. There, a sleep specialist can help you determine your need for further evaluation. […] An evaluation often involves overnight monitoring of your breathing and other body functions during sleep testing at a sleep center. Home sleep testing also might be an option. Tests to detect sleep apnea include: […] Your health care provider might provide you with simplified tests to be used at home to diagnose sleep apnea. These tests usually measure your heart rate, blood oxygen level, airflow and breathing patterns. […] If the results aren’t typical, your provider might be able to prescribe a therapy without further testing.

• #4 Understanding Sleep Apnea Diagnosis and Treatment

  https://sleepcyclecenters.com/blog/how-is-sleep-apnea-diagnosed/

  Questions during an appointment will usually focus on sleep behavior, such as how long a patient sleeps and how they feel during the day. […] The Epworth Sleepiness Scale (ESS) is a widely used assessment tool for patients with suspected obstructive sleep apnea (OSA) and other sleep conditions (OSA). […] The final score is then used to determine if a person is suspected of having a sleep disorder, such as sleep apnea. […] A score of 16 to 24 on an Epworth Sleepiness Scale may warrant further investigations with a sleep clinic to rule out any suspected medical conditions, such as sleep apnea and apnea sleep. […] Once a patient has completed the initial stages of a sleep apnea assessment, a doctor may refer them to a sleep specialist for more comprehensive screenings of sleep disorders.

• #5 How to Tell If You Have Sleep Apnea (And How a CBCT Scan Can Help)

  https://revealdiagnostics.com/blog/how-to-tell-if-you-have-sleep-apnea/

  Sleep apnea is one of the most common sleep disorders, though its often undiagnosed or misdiagnosed. […] To find out if you have sleep apnea, your doctor will ask you questions about your sleeping patterns and symptoms. Your doctor may also ask you to fill out an Epworth Sleepiness Scale questionnaire which helps determine how likely it is that you have sleep apnea. […] A sleep study called a polysomnography can also be used to diagnose sleep apnea. This test records brain waves, heart rate, blood pressure, breathing patterns and eye movements during the night and is more accurate than self-reported questionnaires in diagnosing the condition. […] If your doctor suspects that you have sleep apnea or another type of breathing disorder, he or she may recommend that you get a CT scan of your airways. The CBCT machine at Reveal Diagnostics uses multiple views of the patient’s throat area to create a 3D rendering of their airway space with details as small as one millimeter.

• #6 Obstructive sleep apnea – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/obstructive-sleep-apnea/diagnosis-treatment/drc-20352095

  A member of your health care team evaluates your condition based on your symptoms, an exam, and tests. You may be referred to a sleep specialist for further evaluation. […] A sleep specialist can further evaluate you. The specialist can diagnose and determine the extent of your condition. The specialist also can plan your treatment. The evaluation might involve staying at a sleep center overnight. At the sleep center, your breathing and other body functions are monitored as you sleep. […] Tests to detect obstructive sleep apnea include: Polysomnography. During this sleep study, you’re hooked up to equipment that monitors your heart, lung and brain activity and breathing patterns while you sleep. […] Under certain circumstances, you may have an at-home version of polysomnography to diagnose obstructive sleep apnea. Home sleep apnea testing kits monitor a limited number of variables to detect breathing pauses during sleep.

• #7 Sleep apnea – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/sleep-apnea/diagnosis-treatment/drc-20377636

  If you have obstructive sleep apnea, your health care provider might refer you to an ear, nose and throat specialist to rule out a blockage in your nose or throat. […] An evaluation by a heart specialist, known as a cardiologist, or a doctor who specializes in the nervous system, called a neurologist, might be necessary to look for causes of central sleep apnea.

• #8 Diagnosing Sleep Apnea | SleepApnea.org

  https://www.sleepapnea.org/diagnosis/?srsltid=AfmBOopeC-pH42B-GWPaqWXV7DT9Ig7dvbvuj5WmFyyWWQQR9VIvGYcL

  A growing number of people in the United States are being diagnosed with sleep apnea, a disorder characterized by repeated pauses in breathing, most often due to airway obstruction. […] In order to plan treatment, an accurate diagnosis must be made. […] Learning about sleep apnea can help you have an informed discussion with your doctor about the diagnostic process and next steps for care. […] A diagnosis of sleep apnea can only be made after a sleep study confirms you are experiencing breathing problems in your sleep. […] If the doctor suspects sleep apnea based on your exam and symptoms, they will likely recommend that you have a sleep study. […] A polysomnogram is a sleep study in which medical sensors are used to monitor a person’s breathing, heart rate, and the electrical activity of their brain waves while they sleep.

• #9 Diagnosis and treatment of obstructive sleep apnea in adults

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5714700/

  Obstructive sleep apnea (OSA) is likely underdiagnosed in Canada; however, lack of appropriate treatment puts many at risk of poor quality of life, comorbidity, motor vehicle crashes and increased health care utilization. […] Polysomnography is the gold standard for diagnosis; however, home sleep apnea testing may be used to confirm the diagnosis in symptomatic patients with a high pretest probability of OSA and without clinically important cardiopulmonary comorbidity. […] By consensus, the International Classification of Sleep Disorders defines OSA as the presence of symptoms or certain comorbidities associated with five or more predominantly obstructive respiratory events per hour or by 15 or more predominantly obstructive respiratory events per hour in asymptomatic patients. […] The gold standard for diagnosis of OSA is attended polysomnography (level I study), which involves collection of seven or more data channels, including electroencephalogram and electrooculogram for sleep staging, electromyogram, electrocardiogram and respiratory channels.

• #10 Obstructive Sleep Apnea Diagnosis & Testing NYC | Mount Sinai – New York

  https://www.mountsinai.org/care/ent/services/sleep-surgery/diagnosis-testing

  Obstructive Sleep Apnea Diagnosis and Testing […] An evaluation of the head and neck through an office visit with an otolaryngologist can be a great start for determining if you or a loved one has obstructive sleep apnea. […] The primary definitive method of diagnosing whether you have sleep apnea is through an overnight sleep study or polysomnography (PSG). […] An overnight PSG is considered the gold standard for diagnosing sleep apnea. […] Home sleep studies are also performed now and are often required for initial screening by insurance companies. […] If a home sleep study is negative and your examination and history point to a high likelihood of OSA, a full sleep study may be ordered afterward. […] Otolaryngologists specializing in sleep apnea treatment often perform diagnostic exams to better evaluate your airway:

• #11 Sleep Apnea Diagnosis: How Doctors Test You for Sleep Apnea

  https://www.webmd.com/sleep-disorders/sleep-apnea/diagnosing-sleep-apnea

  If you have symptoms of sleep apnea, your doctor may ask you to have a sleep apnea test, called a polysomnogram (PSG). This may be done in a sleep disorder center or even at home. […] A polysomnogram — or sleep study — is a multiple-component test that electronically sends and records specific physical activities while you sleep. The recordings are analyzed by a qualified sleep specialist to find out if you have sleep apnea or another type of sleep disorder. […] If the test shows sleep apnea, you may need more sleep testing to figure out the best treatment option. […] In the morning, the technicians take off the sensors attached to your skin, and you go back to your everyday activities. […] It takes the sleep specialist some time to go over the hundreds of pages of data from the study. Theyll send the results to your doctor. Once your doctor reviews them, youll meet to talk about the findings and next steps. […] The data will include information about your sleep, such as: How long you spend in each sleep stage, How often you wake up, Whether you stop breathing or have trouble breathing, Whether you snore, Body position, Limb movements, Unusual brain activity patterns.

• #12 NCD – Sleep Testing for Obstructive Sleep Apnea (OSA) (240.4.1)

  https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?NCDId=330&NCDver=1

  Obstructive sleep apnea (OSA) is the collapse of the oropharyngeal walls and the obstruction of airflow occurring during sleep. Diagnostic tests for OSA have historically been classified into four types. The most comprehensive is designated Type I attended facility based polysomnography (PSG), which is considered the reference standard for diagnosing OSA. Attended facility based polysomnogram is a comprehensive diagnostic sleep test including at least electroencephalography (EEG), electro-oculography (EOG), electromyography (EMG), heart rate or electrocardiography (ECG), airflow, breathing/respiratory effort, and arterial oxygen saturation (SaO2) furnished in a sleep laboratory facility in which a technologist supervises the recording during sleep time and has the ability to intervene if needed. Overnight PSG is the conventional diagnostic test for OSA. The American Thoracic Society and the American Academy of Sleep Medicine have recommended supervised PSG in the sleep laboratory over 2 nights for the diagnosis of OSA and the initiation of continuous positive airway pressure (CPAP).

• #13 Diagnosing Sleep Apnea | SleepApnea.org

  https://www.sleepapnea.org/diagnosis/?srsltid=AfmBOopeC-pH42B-GWPaqWXV7DT9Ig7dvbvuj5WmFyyWWQQR9VIvGYcL

  If the doctor thinks it’s very likely that you have sleep apnea, they may order a sleep study with the potential to trial a positive air pressure (PAP) device. […] A home sleep apnea test (HSAT) may be an option for people who are suspected of having moderate to severe obstructive sleep apnea based on their symptoms, medical history, and physical exam. […] A diagnosis of obstructive sleep apnea is based on the results of the polysomnogram and the presence or absence of certain symptoms. […] Sleep apnea is diagnosed if at least 5 breathing events per hour of sleep are recorded during the sleep study. […] A diagnosis of central sleep apnea also requires careful consideration of a person’s symptoms and polysomnography results.

• #14 Home sleep apnea testing for obstructive sleep apnea in adults – UpToDate

  https://www.uptodate.com/contents/home-sleep-apnea-testing-for-obstructive-sleep-apnea-in-adults

  Home sleep apnea testing (HSAT; also referred to as out-of-center sleep testing or portable monitoring) can be used as an alternative to overnight, attended, in-laboratory polysomnography for both the diagnosis of OSA and for following the response to therapy. […] The types of devices used for HSAT and the indications and limitations of HSAT are reviewed here. […] Type 1 devices (attended polysomnogram) are used for technician-attended, overnight polysomnography (PSG), typically done in a sleep laboratory setting. […] Home devices — Types 2, 3, and 4 devices are portable devices. The most common HSAT devices in use are type 3 and type 4 devices.

• #15 NCD – Sleep Testing for Obstructive Sleep Apnea (OSA) (240.4.1)

  https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?NCDId=330&NCDver=1

  Effective for claims with dates of service on and after March 3, 2009, the Centers for Medicare Medicaid Services finds that the evidence is sufficient to determine that the results of the sleep tests identified below can be used by a beneficiarys treating physician to diagnose OSA, that the use of such sleep testing technologies demonstrates improved health outcomes in Medicare beneficiaries who have OSA and receive the appropriate treatment, and that these tests are thus reasonable and necessary under section 1862(a)(1)(A) of the Social Security Act. […] Type I PSG is covered when used to aid the diagnosis of OSA in beneficiaries who have clinical signs and symptoms indicative of OSA if performed attended in a sleep lab facility. […] Type II or Type III sleep testing devices are covered when used to aid the diagnosis of OSA in beneficiaries who have clinical signs and symptoms indicative of OSA if performed unattended in or out of a sleep lab facility or attended in a sleep lab facility.

• #16 Diagnosis and treatment of obstructive sleep apnea in adults

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5714700/

  In symptomatic patients with a moderate-to-high pretest probability of OSA and no substantial cardiopulmonary comorbidity, level III studies are adequate for the diagnosis of OSA. […] If results for home sleep apnea testing are negative in a patient for whom there is a high index of suspicion, physicians should seek testing using polysomnography.

• #17 Diagnosis and Treatment of Obstructive Sleep Apnea in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0901/p355.html

  An apnea-hypopnea index of 15 or more events per hour, or five or more events per hour in the presence of symptoms or cardiovascular comorbidities, is diagnostic for OSA. […] Overnight polysomnography performed in a sleep laboratory in the presence of an attendant is considered the first-line diagnostic study and is classified as a type-I study. […] In general, home sleep apnea tests are considered to be less accurate than type-I studies because of data loss from detached or malfunctioning monitoring equipment. […] Home sleep apnea tests can be an alternative to type-I studies in patients who are unable to present to a sleep laboratory.

• #18 Sleep Apnea: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/8718-sleep-apnea

  A healthcare provider will diagnose sleep apnea by asking you questions about your symptoms and medical history. If they suspect the condition, they’ll recommend testing to confirm a diagnosis. […] The most common tests for sleep apnea include: Polysomnogram. This is an overnight test that involves wearing sensors that monitor your heart rate, breathing, blood oxygen levels, brain waves and more. […] Healthcare providers use the apnea/hypopnea index (AHI) to determine the severity of a sleep apnea diagnosis. The AHI measures the average hourly number of apnea (when you stop breathing while asleep) and hypopnea (decreased airflow) events. […] A healthcare provider will recommend different treatment options based on the type of sleep apnea and the severity. These may include: Using a breathing device like a continuous positive airway pressure (CPAP) machine.

• #19 Diagnosis and Treatment of Obstructive Sleep Apnea in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0901/p355.html

  Obstructive sleep apnea is a common disorder that causes patients to temporarily stop or decrease their breathing repeatedly during sleep. […] The diagnostic standard for obstructive sleep apnea is nocturnal polysomnography in a sleep laboratory. […] In addition to risk factors, numerous signs and symptoms can suggest OSA, but polysomnography is the diagnostic standard. […] Predictive clinical features of OSA include observed gasping during sleep, morning headache, excessive daytime sleepiness, loud snoring, and neck circumference of greater than 16 inches (40.6 cm). […] Sleep studies performed in a sleep laboratory or in the home can quantify the apnea-hypopnea index, which is required to diagnose OSA. Apnea is a complete obstruction of airflow, and hypopnea is a partial obstruction of airflow; both must last a minimum of 10 seconds.

• #20 Sleep apnoea

  https://www.nhs.uk/conditions/sleep-apnoea/

  Sleep apnoea needs to be treated because it can lead to more serious problems. […] Sleep apnoea can be serious if it’s not diagnosed and treated. […] If a GP thinks you might have sleep apnoea, they may refer you to a specialist sleep clinic for tests. […] The test can show if you have sleep apnoea and how severe it is. […] Your AHI score shows how severe your sleep apnoea is: AHI of 5 to 14 = mild, AHI of 15 to 30 = moderate, AHI over 30 = severe. […] Sleep apnoea can sometimes be treated by making lifestyle changes like losing weight, giving up smoking and reducing how much alcohol you drink. […] If you’ve been diagnosed with sleep apnoea, there are some things you can do to help. […] Without treatment, sleep apnoea can lead to other problems including high blood pressure, a higher chance of having a stroke, type 2 diabetes, heart disease, depression or mood changes. […] Sleep apnoea happens if your airways become too narrow while you sleep. This stops you breathing properly.

• #21 Obstructive Sleep Apnea (OSA) Differential Diagnoses

  https://emedicine.medscape.com/article/295807-differential

  A diagnosis of narcolepsy may be delayed if obstructive sleep apnea (OSA) is considered the only condition. Patients should be routinely screened clinically for symptoms of narcolepsy. These patients do not typically have normal sleepiness when OSA has been treated; they may experience improvement in sleepiness, but it is important to question the diagnosis of sleepiness due to OSA despite ideal treatment. […] The indices commonly used to assess sleep disordered breathing (SDB) are the apnea-hypopnea index (AHI) and the respiratory disturbance index (RDI). […] According to the Centers for Medicare Medicaid Services criteria for the positive diagnosis and treatment of obstructive sleep apnea, a positive test for OSA is established if either of the following criteria using the AHI or the RDI is met: AHI or RDI greater than or equal to 15 events per hour, or AHI or RDI greater than or equal to 5 and less than or equal to 14 events per hour with documented symptoms of excessive daytime sleepiness (EDS); impaired cognition; mood disorders; insomnia; or documented hypertension, ischemic heart disease, or history of stroke.

• #22 Obstructive Sleep Apnea Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6140019/

  The severity of OSA is determined by an index Apnea Hypopnea Index (AHI) or Respiratory Disturbance Index (RDI), if PSG is performed, or Respiratory Event Index (REI) if OCST is performed. […] Snoring and daytime sleepiness are the most common symptoms in patients with OSA. […] The sleep tests are classified depending on the number of channels being monitored during the test. Type 1 test is the in-lab attended sleep study or polysomnography (PSG), which is the gold standard test to diagnose OSA. […] Moderate or severe OSA should always be treated due to significantly increased risk of cardiovascular and all-cause mortality if untreated. […] The AASM recommends positive airway pressure (PAP) as the treatment of choice for all severities of OSA. […] Continuous fixed positive pressure (CPAP) applied to the upper airway acts as a pneumatic splint and prevents collapse of the upper airway during inspiration.

• #23 Diagnosis and Treatment of Obstructive Sleep Apnea for Adults | BCBSND

  https://www.bcbsnd.com/providers/policies-precertification/medical-policy/d/diagnosis-and-treatment-of-obstructive-sleep-apnea-for-adults

  Obstructive sleep apnea (OSA) diagnosis is based upon the presence or absence of related symptoms, as well as the frequency of respiratory events during sleep (e.g., apneas, hypopneas, and respiratory effort related arousals [RERAs]) as measured by polysomnography (PSG) either in a clinic/facility or at home. […] OSA severity classification is based on two (2) measures: Apnea/hypopnea index (AHI) which includes the total number of apneas and hypopneas recorded during sleep, divided by the hours of sleep recorded; or Respiratory disturbance index (RDI) which includes the total number of apneas, hypopneas, and RERA during sleep, divided by the hours of sleep observed. […] A home sleep study in individuals greater than (>) 18 years of age that includes a minimum of four (4) recording channels including oxygen saturation, respiratory movement, airflow, and EKG or heartrate or peripheral arterial tone (PAT), oximetry, heart rate and actigraphy is considered medically necessary if ALL the following criteria are met: At least two (2) or more of the following must be present: Observed apneas during sleep; or Frequent snoring or choking/gasping during sleep; or Excessive daytime sleepiness documented by history or with an Epworth Sleepiness Scale greater than (>) ten (10); or Treatment resistant hypertension; or Obesity with Body Mass Index (BMI) greater than (>) 35kg/m2; or Individuals scheduled for bariatric surgery; or STOP-BANG score of greater than (>) five (5); or Coronary Artery Disease; or Cardiac Disease; or Diabetes; or Crowded airway.

• #24 Obstructive Sleep Apnea Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6140019/

  The Centers for Medicare Medicaid Services (CMS) approves CPAP use in patients with moderate or severe OSA (AHI 15) and in patients with mild OSA (AHI 5 14.9) that have documentation of one of the following: excessive daytime sleepiness, hypertension, ischemic heart disease, history of stroke, impaired cognition, mood disorder, or insomnia. […] Although CPAP is extremely effective, one fourth to one half of patients with OSA have substantial difficulty tolerating CPAP. […] The Winx Sleep Therapy System provides a light negative pressure in the oral cavity through an individually fitted soft mouthpiece connected to a quiet vacuum by tubing. […] Another promising emerging treatment of OSA involves stimulation of the upper airway via an implantable neurostimulator. […] OSA is a serious illness affecting about 12% of adults in the US. The majority of patients are undiagnosed posing serious healthcare and economic burden.

• #25 Obstructive Sleep Apnea Diagnosis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/sleep/obstructive-sleep-apnea/diagnosis.html

  The gold standard for diagnosis is a Polysomnography (PSG), or, sleep study. This test is performed while the patient is asleep at a sleep laboratory, and monitors brain waves, blood oxygen levels, heart rate and breathing, as well as eye and leg movements. […] However, the sleep test itself does not provide the location of the obstruction, so evaluation methods of the upper airway are necessary to identify potential sites of collapse that lead to OSA. […] Nasopharyngoscopy is an office procedure in which a flexible fiberoptic endoscope is introduced through the nose and throat to observe anatomical structures that narrow the airway and compromise airflow and cause snoring. […] Sleep endoscopy is similar to Nasopharyngoscopy, however it is performed under mild sedation (with an hypnotic drug, such as propofol) and it is an outpatient procedure. The objective of this test is to reproduce what occurs to the patient’s upper airway in a sleep state, and identify structures and areas causing the obstruction.

• #26 Obstructive Sleep Apnea Diagnosis & Testing NYC | Mount Sinai – New York

  https://www.mountsinai.org/care/ent/services/sleep-surgery/diagnosis-testing

  Fiberoptic Nasolaryngoscopy – this diagnostic tool is a standard part of the initial office visit and is an office based scope exam. […] Drug Induced Sleep Endoscopy (DISE) – this diagnostic tool is a nasolaryngoscopy performed under sedation to examine the airway while the patient is falling asleep. […] DISE is an extremely useful tool to more accurately ascertain the anatomic reasons behind sleep apnea, and to allow for more targeted therapy if surgery is decided upon.

• #27 Diagnosis and Management of Obstructive Sleep Apnea: Updates and Review

  https://www.mdpi.com/2504-463X/5/2/16

  This clinical implication has led to further pursuit in the understanding of the heterogeneity of OSA to improve the diagnosis and treatment of the disorder. […] The usage of biomarkers has been studied to augment phenotyping approaches. […] These biomarkers may help to screen for the presence of OSA. […] The addition of awake endoscopy has been helpful in evaluating upper airway anatomy and airway obstruction patterns between the upright and supine positions. […] Drug-induced sleep endoscopy is the current preferred diagnostic technique to assess the dynamic upper airway in a state that mimics natural sleep in patients with obstructive sleep apnea. […] The 2017 guidelines focused on diagnostic updates on OSA. The diagnostic assessment of OSA must encompass a comprehensive sleep evaluation, along with polysomnography as the gold standard test.

• #28 Obstructive Sleep Apnea Diagnosis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/sleep/obstructive-sleep-apnea/diagnosis.html

  Still under our research protocols, imaging methods such as computerized tomography scans (CTs), awake and sleep magnetic resonance imaging (MRI) may provide useful information as well in select candidates. […] These tools should be used together to establish a diagnosis and guide the physician’s decision-making towards the appropriate treatment for each patient.

• #29 Sleep apnea – Wikipedia

  https://en.wikipedia.org/wiki/Sleep_apnea

  In unclear cases, multiple nights of testing might be required to achieve an accurate diagnosis. […] Nighttime in-laboratory Level 1 polysomnography (PSG) is the gold standard test for diagnosis. […] The diagnosis of CSA syndrome is made when the presence of at least 5 central apnea events occur per hour. […] Like in OSA, nocturnal polysomnography is the mainstay of diagnosis for CSA.

• #30 Central Sleep Apnea Syndromes Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/304967-workup

  The laboratory findings in persons with central sleep apnea syndromes are not helpful except for a finding of respiratory alkalosis (PaCO2 40 mm Hg while awake) in patients with primary central sleep apnea, high-altitude periodic breathing, and CSB. […] Patients with heart failure and high-altitude periodic breathing may also have relative or absolute hypoxia shown with arterial blood gas analysis. […] The American College of Physicians has provided new guidelines on the diagnosis of sleep apnea, as follows: Patients with unexplained daytime sleepiness should undergo a sleep study, preferably polysomnography (PSG). […] Most diagnoses of central sleep apnea are made on the basis of PSG studies. […] The ICSD-3TR diagnostic criteria specifies that there must at least 3 consecutive central apneas and/or hypopneas, separated by a crescendo and decrescendo change in breathing amplitude (periodic breathing) and 5 central events per hour associated with the periodic breathing over a minimum of 2 hours.

• #31 Diagnosing Obstructive Sleep Apnea: Tests and Treatment | SleepApnea.org

  https://www.sleepapnea.org/obstructive-sleep-apnea/diagnosis/?srsltid=AfmBOoqs4xKz6CeSlcWQOQ-YCBpYp10yg3MzwqRPoNsNJYabdcMDUX31

  Obstructive sleep apnea (OSA) is a common sleep disorder in which repeated breathing disruptions reduce the quality of a person’s sleep and contribute to potentially serious health complications. Diagnosing and treating OSA early can improve breathing during sleep, reduce symptoms and long-term health risks, and enhance overall quality of life. […] Obstructive sleep apnea is diagnosed based on the results of an overnight test that evaluates breathing during sleep. To determine whether a sleep apnea test is needed, a doctor considers a person’s symptoms, risk factors, and the results of a physical exam. […] If, after a thorough assessment, a doctor suspects that a person may have obstructive sleep apnea, they will recommend sleep apnea testing that can diagnose OSA, determine its severity, and help identify the optimal treatment.

• #32 Diagnosing Obstructive Sleep Apnea: Tests and Treatment | SleepApnea.org

  https://www.sleepapnea.org/obstructive-sleep-apnea/diagnosis/?srsltid=AfmBOoqs4xKz6CeSlcWQOQ-YCBpYp10yg3MzwqRPoNsNJYabdcMDUX31

  A sleep apnea test is an overnight test that is necessary to confirm a diagnosis of obstructive sleep apnea. […] Once a sleep apnea test is complete, the doctor will evaluate the results to determine whether a person has obstructive sleep apnea. To diagnose obstructive sleep apnea, the doctor will consider a person’s symptoms and how often their breathing is paused or restricted during sleep, called their apnea-hypopnea index. […] After a home sleep apnea test is complete, the results will be reviewed during a follow-up visit with the doctor. Based on the number of breathing disruptions detected, an at-home test can be used to diagnose OSA. […] Once a diagnosis of obstructive sleep apnea is confirmed, a health care provider can recommend appropriate treatment. The focus of treatment is to reduce symptoms and long-term health risks by preventing the airway from becoming blocked while a person sleeps. […] There are a variety of treatments for obstructive sleep apnea. Doctors determine the appropriate treatment based on the severity of the condition and a person’s overall health.

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