How is sleep apnea diagnosed?
A primary care physician is normally first seen by seniors who believe they have sleep apnea. The primary care physician will usually refer patients with the signs and symptoms of sleep apnea to a sleep specialist. These sleep specialists are physicians who diagnose and treat people with sleep problems, including sleep apnea. The sleep specialist physician will usually begin by conducting a medical and family history workup by asking the patient or his/her family members questions about their quality of sleep, daytime functioning, and current mental status. The sleep specialist may then conduct a physical exam to inspect the mouth, nose and throat for extra large tissues that may be causing an obstruction during sleep. Most adult patients, including seniors, are then asked to participate in a sleep study. A sleep study remains the gold standard in diagnosing sleep apnea in adults. A sleep study is often conducted at a specialized sleep center or sleep lab. The most common type of sleep study conducted in diagnosing sleep apnea is a polysomnogram, or PSG. A PSG is a painless, continuous test that uses sensors on the scalp, face, chest, arms and fingers to measure many key bodily activities while the patient sleeps throughout the night. The results from these measurements are interpreted by the sleep specialist to determine whether sleep apnea exists and also the severity if it does in fact exist. Sleep specialists often use what is called an Apnea-Hypopnea Index (AHI) to determine the severity of sleep apnea for a specific patient. An AHI reports both the episodes of breathing pauses during sleep that lasts ≥ 10 seconds and episodes of abnormally shallow breathing or a slow respiratory rate with a decrease of ≥ 50% of airflow and a decrease of ≥ 3% of oxygen saturation levels within the blood. The AHI for a given patient is reported as episodes per hour. The AHI ranking of sleep apnea severity is provided below:
- Mild – 5 to 15 episodes per hour
- Moderate – 15 to 30 episodes per hour
- Severe – > 30 episodes per hour