Confronting a potential medical issue is the first hurdle for many patients when seeking help for sleep apnea. Still, many feel overwhelmed by where to start or if medical professionals will take their concerns seriously. Understanding the assessment, screening, and referral process helps many patients navigate their diagnosis, ensuring they get the help they need to manage their condition efficiently.
Reviewing a patient’s medical history and the physical assessment
A doctor may begin with a discussion regarding symptoms, questions about family history, and a physical examination of the mouth, throat, and neck. This is an opportunity for patients to raise concerns and learn more about the referral process for sleep conditions, such as sleep apnea and sleep studies. We highly recommend preparing a detailed sleep diary before the initial appointment, detailing symptoms, sleep quality, and episodes of snoring reported by partners to ensure a doctor has a clear overview to work with.
Preparing for your sleep apnea assessment
Questions during an appointment will usually focus on sleep behavior, such as how long a patient sleeps and how they feel during the day. These questions will clarify a person’s daily pattern and overall health, reviewing if a potential sleep issue triggers unpleasant symptoms and complications. At this stage, lifestyle, medications, or other health conditions may also be considered, as well as a family history of sleep problems in close relatives, including obstructive apnea.
Common sleep apnea questions asked by doctors:
- How tired do you feel during the day?
- Do you take naps, how many, and for how long?
- Are you able to stay awake while driving or watching the tv?
- Have you smoked?
- Do you know anyone in your family with sleep apnea?
- Has anyone ever told you that you snore?
Scoring Apnea on the Epworth Sleepiness Scale
The Epworth Sleepiness Scale (ESS) is a widely used assessment tool for patients with suspected obstructive sleep apnea (OSA) and other sleep conditions (OSA). This series of questions is scored by the likelihood of falling asleep during specific day-to-day activities to highlight to a doctor the intensity of a patient’s daytime sleepiness. The final score is then used to determine if a person is suspected of having a sleep disorder, such as sleep apnea.
Check your Epworth Sleepiness Scale results:
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.
Evaluating Sleep Apnea with specialized sleep studies
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. A sleep study is one of the most accurate ways to diagnose sleep apnea. There are two types of sleep tests, one where you sleep for a night in a sleep lab and one where you seep into your bed while wearing sleep monitoring equipment, such as a CPAP machine. The latter is our test at The Sleep Cycle Center, as our patients are more comfortable sleeping in their homes.
Understanding the results of a Polysomnography
A sleep test will score breathing episodes based on the Apnea-Hypopnea Index (AHI), recording abnormalities in one hour. These are sectioned into two categories; apnea – when a patient stops breathing entirely for a minimum of 10 seconds, and hypopnea – the number of times breathing is partially blocked. Brain activity and general movement during sleep will also be monitored during the evaluation process.
How an Apnea-Hypopnea Index (AHI) scores apnea cases
The scoring of an Apnea-Hypopnea Index (AHI) is used alongside a patient’s medical records, reviewing their family history and previously reported health issues or symptoms. An apnea diagnosis is then confirmed by a 3-tier scoring method, with higher scores suggestive of more severe apnea cases, such as apnea obstructive.
Here are the three scorings for the Apnea-Hypopnea Index (AHI):
- Mild sleep apnea: AHI 5-15
- Moderate sleep apnea: AHI 15-30
- Severe sleep apnea: AHI greater than 30
Apnea tests in the comfort of your own home
A single-use home sleep test can be an accurate and convenient way to screen for sleep apnea without requiring a hospital stay. Many people prefer this testing method, away from sleeping in an unknown environment such as a sleep lab. Almost all of our recorded diagnoses occur through home testing, encouraging undiagnosed patients to seek help for apnea symptoms through new, more approachable testing methods, such as apnea tests.
Understanding the Results of a Home Sleep Test
A device (similar to a sports watch) is fitted to a patient’s wrist, sending data to our sleep providers for analysis. Measurements of the person’s heart rate, oximetry, actigraphy, body position, snoring episodes, and chest movements are recorded over a specific period to build a detailed overview of a patient’s daily sleeping pattern, pinpointing signs and symptoms common with apnea.
Similar to a sleep test in a lab, a home testing device can measure abnormalities in bodily functions that are suggestive of sleep apnea:
- Apnea Hypopnea Index (AHI)
- Central Apnea Hypopnea Index (CAHI)
- Respiratory Disturbance Index (RDI)
- Oxygen Desaturation Index (ODI)
- REM/Deep/Light Sleep stages
- Body position and chest movements
- Heart Rate
- Pulse Oximetry
Innovative cloud-based apnea testing
At The Sleep Cycle Center, we have invested in the latest technology and medical guidance to ensure high-quality and accurate apnea screening services for patients. Partnering with the Watchpat One, an innovative Home Sleep Apnea Device (HSAT), we can review AHI, AHIc, RDI, and ODI based on True Sleep Time and Sleep Staging. This device is efficiently linked to a cloud-based system, allowing our sleep providers to review the results from the test while a patient sleeps comfortably in their bedroom.
Contact Sleep Cycle Centers for reliable and comfortable apnea screenings
The Sleep Cycle Center takes a holistic view of managing the care of sleep disorders, including home testing and treatments that can be conveniently adapted into a patient’s day-to-day life. Suppose you or your doctor are concerned about a suspected apnea diagnosis, or you are taking the first steps in the assessment process or starting the initial referral process. In that case, our free Sleep Assessment Form is over 90% successful at identifying individuals with sleep apnea within 48 hours. Follow the link to get started, or call our team to learn more.