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Diagnosing Sleep Apnea

Your health care provider will conduct a physical examination and medical history, including asking questions about your sleep patterns. Your provider may also examine your nose and throat to see whether you have any physical obstructions (e.g., enlarged tongue or tonsils).

You may be asked to complete the Epworth Sleepiness Scale (ESS), a questionnaire that helps measure your general level of daytime sleepiness. Because significant others tend to be more accurate in reporting their partner's daytime sleepiness to a doctor, your health care professional may wish to speak with your partner, too.

If OSA or another sleep disorder is suspected, an overnight sleep study called a polysomnogram may be recommended as part of the assessment—both to confirm the presence of sleep apnea and to determine its severity, as well as to exclude the presence of other sleep disorders. During this test you are connected to noninvasive equipment that monitors your brain activity (EEG), breathing patterns, eye movements (EOG), muscle activity (EMG), heart rate and rhythm (EKG), leg movements and blood oxygen levels throughout the night. This helps your health team assess your body's functioning during different stages of sleep. None of these tests is typically painful.

A common measurement of the severity of sleep apnea is the apnea-hypopnea index (AHI), which is the average number of all apneas (interruptions in breathing) and hypopneas (episodes of abnormally shallow breathing) that occur per hours of sleep. According to the American Academy of Sleep Medicine (AASM), the severity of OSA can be categorized as follows:

• Mild OSA: AHI of 5 to 15
• Moderate OSA: AHI of 15 to 30
• Severe OSA: AHI of more than 30

Such evaluations are usually covered by health insurance, but you should check with your carrier first. Your health care provider will probably recommend a specific sleep center, which should be accredited by the AASM.

Home-based monitoring systems are available for diagnosing sleep apnea. However, these tests are often more difficult to interpret than a sleep study performed in a laboratory and should typically be administered only by practitioners with extensive training and experience in sleep medicine.

Gender Differences: Recognizing and Communicating About OSA

Women are less likely to be correctly diagnosed with OSA even when symptoms are reported. As mentioned, many dismiss ES as an inevitable consequence of their hectic lifestyles, juggling work and family life. However, such exhaustion can signal serious health problems, including OSA.

Make sure you aren't ignoring the signs of OSA:

• Talk openly with your health care professional. Share details about your sleep patterns and energy and concentration levels during the day. You may want to keep a journal to chronicle how you feel during the day (e.g., are you forgetting things? Do you feel sleepy at unusual times, such as when talking on the phone or even while driving?).

• Know how to recognize signs and symptoms. Women with OSA may be more likely to report fatigue, morning headaches, insomnia and depression. The likelihood of having OSA increases for women after menopause.

• Ask about sleep tests used to diagnosis the condition.

• Ask your sleep partner if you snore or make gasping sounds during the night.

If you or your partner snore loudly (especially when snores are interrupted by periods of silence when airflow is reduced or blocked) enough to disturb either one of you, you should talk with your health care provider.