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How To Test For Obstructive Sleep Apnea

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How Do I Know I Have Osa

Home Sleep Testing to Diagnose Obstructive Sleep Apnea

The gold standard for diagnosis is a Polysomnography , 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. A home monitoring device may be a useful alternative for some patients under the guidance of a knowledgeable sleep professional.

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 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.

Still under our research protocols, imaging methods such as computerized tomography scans , awake and sleep magnetic resonance imaging may provide useful information as well in select candidates. CTs are routinely used in the pre-operative evaluation of patients who undergo any surgery that involves the facial skeleton such as maxillomandibular advancement.

Airway blocked during sleep

What Is The Intus Healthcare Sa In

This;affordable in-home sleep test;uses medical-grade equipment to assess your sleep and is delivered by courier directly to your home. Overnight oximetry uses a small device worn on the finger to measure your blood oxygen levels as well as your heart rate.

This detailed sleep test also measures body movements and position, snoring intensity and a key indicator of a respiratory disturbance called peripheral arterial tone. You will also be expected to complete a medical questionnaire.

Our specially trained NHS healthcare professionals evaluate the results, and you will usually receive a confidential diagnosis within 13 weeks.

More Sleep Study Information

About Polysomnography Overnight Sleep Studies

The most thorough way to test for sleep apnea is to have an overnight stay at a sleep clinic, called polysomnography, or PSG.

The cost of such overnight stays in Canada is covered by the Medical Services Plan of your province.

The PSG measures breathing and apneas, chest movement, oxygen levels, REM, leg movement, brain activity and heart rate through about 25 external probes attached to your head, neck, chest, and legs. None of these tests require the puncturing of the skin. These measurements are monitored throughout the night.

It is matter of discussion and opinion whether all this information is essential to diagnose OSA, , but this extra information will help diagnose other less common breathing disorders as well as other medical conditions such as heart failure and brain disorders.

If sleep apnea is confirmed by PSG, most sleep specialists will insist on a second overnight stay, where again the probes will be attached, as well as a face mask. Varying air pressures will be applied throughout the night to determine the optimal settings for the patient.

Many possible sleep apnea sufferers do not want the inconvenience and commitment of a night away from home. There is also considerable delay in obtaining a bed in public sleep clinics, ranging from 1 to 6 months.

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Guidelines Recommend Sleep Test For Obstructive Sleep Apnea

Daytime sleepiness has become an accepted consequence of our busy lives. We overload our schedules, stay up too late, and even sleep with our smartphones, then walk around yawning and guzzling coffee to stay awake in the afternoon. But if your daytime sleepiness isnt relieved by a few extra Zs now and then, your lifestyle may not be the culprit it could be obstructive sleep apnea.

Obstructive sleep apnea occurs when the muscles in the back of your throat relax too much when you are asleep. This lets the tissues around your throat close in and block the airway. You stop breathing for a few seconds . Your brain has to wake you up enough so you gasp or change positions to unblock the airway. You arent even aware its happening. These stop-breathing episodes can occur dozens of times per hour, making you feel tired the next day. Even worse, they increase blood pressure and heart rate, putting stress on the cardiovascular system and increasing your risk for a stroke.

In the United States, between 12 million and 18 million adults have obstructive sleep apnea and the rates are rising, says the National Heart, Lung, and Blood Institute. Why? Because more and more Americans are overweight or obese. Too much fat in the neck can add to airway blockage during sleep.

Daytime sleepiness is one sign of obstructive sleep apnea. Others include:

How To Treat Tinnitus And Sleep Apnea

AASM releases position statement on home sleep apnea testing

If sleep apnea and tinnitus make it difficult for you to get a sound nights sleep, CPAP therapy can help. Commonly used to treat sleep apnea, CPAP therapy can also minimize tinnitus because of your bodys improved blood oxygen levels. As these levels improve, there is a reduction of pressure on your ears, which simultaneously alleviates tinnitus symptoms.

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How To Treat Obstructive Sleep Apnea

Sleep apnea is a serious sleep disorder that needs to be treated. Your medical provider or a sleep doctor can help you select a treatment plan that is right for you. Depending on the treatment, she may work in collaboration with other members of the sleep team, including dentists, psychologists, physician assistants, nurses and technologists. Your plan may include any combination of these treatments:

American Sleep Apnea Association

We envision a world in which most people suffering from sleep apnea are diagnosed, aware, educated and treated. This serious syndrome, when left untreated has a large influence on quality of life and multiple life-threatening implications. Yet it is highly treatable. Unfortunately it is estimated that more than 80% of people suffering from sleep apnea are undiagnosed. To help those living with sleep apnea, we work relentlessly to promote

  • better awareness in the general public and among health professionals and,
  • affordable, convenient and highly effective diagnoses and treatments.
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    Clinical Pr Actice Recommendations

    The following clinical practice recommendations are based on a systematic review and evaluation of evidence following the GRADE methodology. Remarks are provided to guide clinicians in the implementation of these recommendations. All figures, including meta-analyses and Summary of Findings tables are presented in the supplemental material. shows a summary of the recommendation statements including the strength of recommendation and quality of evidence. A decision tree for the diagnosis of patients suspected of having OSA is presented in .

    Table 5 Summary of recommendations.

    Table 5 Summary of recommendations.

    Figure 2: Clinical algorithm for implementation of clinical practice guidelines.

    The following are good practice statements, the implementation of which is deemed necessary for appropriate and effective diagnosis and management of OSA.

    Stick To A Regular Sleep Schedule

    How to Diagnose Obstructive Sleep Apnea Syndrome

    Going to bed and waking up at roughly the same times every day helps you to get the right kind of sleep. You need to experience the full cycle of deep- and lighter-stage sleep to feel well rested. A regular sleeping schedule also prevents you from getting overtired, which can make sleep apnea symptoms worse.

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    Obstructive Sleep Apnea Test

    If you have difficulty sleeping, problems with snoring, or frequent morning headaches, you might be suffering from obstructive sleep apnea. This is a serious medical issue that can decrease your energy levels and cause you to develop cardiovascular issues. At Dr. Wendy Willoughby, DDS in Asheville, North Carolina, we can use easy, non-invasive methods to diagnose and treat this issue.

    Am I A Good Candidate For Oral Appliance Therapy

    Since oral appliance therapy is a non-invasive, gentle way to address this medical condition, you are likely to benefit from using a customized appliance to improve your breathing. That said, we must assess the condition of your jaw, teeth, and mouth to determine whether this treatment is the right solution for you.

    Examining your mouth and jaw will also allow us to provide you with a customized appliance that is modeled after your own teeth. Since this device will be personalized, you will feel comfortable when you wear your appliance at night.

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    Home Sleep Apnea Test

    Some patients with many risk factors for sleep apnea and no other medical disorders may be candidates for a home sleep apnea test. This type of sleep study lets you sleep in your own home while a small monitor collects data as you sleep. The testing equipment is less complicated than what is used in an in-lab sleep study. You will be shown how to hook up the testing equipment yourself. After your home sleep apnea test, you can take the device back to your medical provider or send it by mail.

    Other apps and sleep tracking devices may claim to be able to detect sleep apnea, but their results can be unreliable. Be sure to discuss these devices with your medical provider.

    After your sleep study or home sleep apnea test, you will schedule a follow-up appointment to discuss the results. If you are diagnosed with sleep apnea, your medical provider will discuss your treatment options with you.

    Diagnosis Of Obstructive Sleep Apnea In Adults Using A Split

    Obstructive Sleep Apnea Treatment Options

    Recommendation 5: We suggest that, if clinically appropriate, a split-night diagnostic protocol, rather than a full-night diagnostic protocol for polysomnography be used in the diagnosis of OSA.

    Remarks: Clinically appropriate is defined as the absence of conditions identified by the clinician that are likely to interfere with successful diagnosis and treatment using a split-night protocol.

    This recommendation is based on a split-night protocol that initiates CPAP titration only when the following criteria are met: a moderate to severe degree of OSA is observed during a minimum of 2 hours of recording time on the diagnostic PSG, AND at least 3 hours are available for CPAP titration.

    Summary

    This recommendation is based on evidence from nine studies that included typical sleep clinic patients studied for symptoms of OSA. The quality of evidence was determined to be low due to imprecision, indirectness, and risk of bias. In the context of an appropriate protocol, a split-night study has acceptable accuracy to diagnose OSA in an uncomplicated adult patient and may improve efficiency of care when performed in the context of adequate clinical and technical expertise. The split-night protocol potentially provides enhanced efficiency of care by diagnosing OSA and establishing PAP treatment needs within a single night recording.

    Discussion

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    Equipment Frequently Used For A Sleep Study

    During a sleep study, surface electrodes will be put on your face and scalp and will send recorded electrical signals to the measuring equipment. These signals, which are generated by your brain and muscle activity, are recorded digitally. Belts around your chest and abdomen measure your breathing. A bandage-like oximeter probe on your finger measures the oxygen in your blood.

    Avoid Alcohol And Sleeping Pills

    If you have trouble sleeping, try a cup of decaffeinated herbal tea or juice instead of unwinding with a glass of wine. Alcohol and certain medications can make throat muscles relax more than normal. As a result, airways can get blocked. Alcohol and medications can also make it harder for your brain to “wake up” and register a lack of oxygen in the body. This can cause longer and more serious pauses in breathing. If you find it hard to fall asleep, try reading a book or taking a warm bath.

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    How Do You Test For Sleep Apnea In Children

    In an electrocardiogram, sensor patches with wires attached measure the electrical impulses given off by your childs heart. Doctors may use this test to determine if your child has an underlying heart condition. Your doctor will work with you to find the most appropriate treatment for your childs sleep apnea.

    Avoid Alcohol And Smoking

    Testing For: Obstructive Sleep Apnea (OSA)

    Lifestyle changes can improve your health and encourage better sleeping habits. Consider quitting smoking and limiting your alcohol intake to reduce sleep apnea complications.

    Alcohol relaxes the throat muscles that control your breathing. This can lead to snoring and an interrupted sleep cycle. It can also lead to inflammation in your airways, blocking your airflow.

    Similar to alcohol, tobacco use can also contribute to inflammation and swelling in your airways. This can worsen your snoring and your sleep apnea.

    A identified smoking as a risk factor for developing sleep apnea. The study noted that people with sleep apnea may have a predisposition to smoking as well, so treating sleep apnea may help in quitting smoking.

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    Polysomnography Is The Standard Diagnostic Test For The Diagnosis Of Osa In Adult Patients In Whom There Is A Concern For Osa Based On A Comprehensive Sleep Evaluation

    Misdiagnosing patients can lead to significant harm due to lost benefits of therapy in those with OSA, and the prescription of inappropriate therapy in those without OSA. As discussed in the recommendations below, sleep apnea-focused questionnaires and clinical prediction rules lack sufficient diagnostic accuracy, and therefore direct measurement of SDB is necessary to establish a diagnosis of OSA. PSG is widely accepted as the gold standard test for diagnosis of OSA. Further, this test has traditionally been used as the gold standard for comparison to other diagnostic tests, including HSAT. Besides the diagnosis of OSA, PSG can identify co-existing sleep disorders, including other forms of sleep-disordered breathing. In some cases, and within the appropriate context, the use of HSAT as the initial sleep study may be acceptable, as discussed in the recommendations below. However, PSG should be used when HSAT results do not provide satisfactory posttest probability of confirming or ruling out OSA.

    The Connection Between Tinnitus And Sleep Apnea

    Now that you understand what tinnitus and sleep apnea are, you might be wondering what the connection is between these two conditions. A recent study looking at sleep disturbances associated with tinnitus found that 69% of patients experienced poor sleep quality. The researchers concluded that for the tinnitus patients to sleep better throughout the night, they needed to reduce the tinnituss intensity.

    But that isnt the only link between sleep apnea and tinnitus. Its believed that obstructive sleep apnea could be a cause of tinnitus. Those with OSA often snore very loudly. Frequent snoring at high frequencies can cause noise-related hearing loss, which can result in tinnitus.

    These two conditions can impact a persons quality of sleep, making it hard for them to go about their daily life. The constant exhaustion negatively impacts all aspects of their life from relationships to career.

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    What Are The Effects Of Sleep Apnea

    If left untreated, sleep apnea can result in a number of health problems including hypertension, stroke, arrhythmias, cardiomyopathy , heart failure, diabetes, obesity and heart attacks.

    Its likely that sleep apnea can cause arrhythmias and heart failure because if you have sleep apnea, you tend to have higher blood pressure. In fact, sleep apnea occurs in about 50% of people with heart failure or atrial fibrillation.

    This is because sleep apnea can cause:

    • Repeated episodes of oxygen lowering .
    • Changes in carbon dioxide levels.
    • Direct effects on the heart due to pressure changes within the chest.
    • Increased levels of markers of inflammation.

    With the high prevalence of sleep apnea in cardiac arrhythmias and heart failure , experts recommend that you dont delay in seeking the advice of your physician.

    Last reviewed by a Cleveland Clinic medical professional on 03/03/2020.

    References

    How To Treat Obstructive Sleep Apnea In Kids And Teens

    Sleep Apnea Therapy

      Surgery, allergy treatment, and orthodontics workSymptoms and Signs of Sleep Apnea in Children

      • snoring
      • attention deficit hyperactivity disorder
      • growth problems

      Tonsillectomy and AdenoidectomyAllergy TreatmentOrthodontic TreatmentMyofunctional TherapyContinuous Positive Airway Pressure Maxillomandibular AdvancementOral ApplianceWeight Loss

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      What Is Narcolepsy

      This is a sleep disorder that causes you to have sudden uncontrollable âsleep attacksâ during the day. It causes you to feel very sleepy and suddenly fall asleep frequently throughout the day. You fall asleep even if itâs noisy or if thereâs activity around you. You find it very difficult to stay awake.

      Narcolepsy can cause sudden sleepiness even when you need to stay awake for your own safety, such as while you drive or cook. You can even keep driving or working while youâre asleep and not remember what you did or said.

      Frequent naps in the daytime may refresh you, but after a couple of hours, youâre tired again.

      Excessive daytime sleepiness and frequently falling asleep are narcolepsyâs most common symptoms. Narcolepsy can cause the following symptoms, too.

      Cataplexy. This is a sudden loss of muscle tone. You may have slurred speech or muscle weakness that causes your knees to buckle or your head to droop. Sudden emotional reactions like laughter or fear may trigger these attacks. Not everyone with narcolepsy has cataplexy.

      Sleep paralysis. You can have a very short loss of the ability to move or speak when you fall asleep or just wake up.

      Fast onset of REM sleep. People who have narcolepsy enter this phase of sleep — the one in which you dream — much more quickly after they fall asleep than other people, even when they fall asleep in the middle of the day.

      Hallucinations. You may see things that arenât there as you are falling asleep or as you wake up.

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