Sleep Apnea Diagnosis

To define Sleep-related Breathing Disorder a Sleep Study is required and interpretation and diagnosis has to be done by a Board Certified physician. There are different sleep study options available as to where you have the sleep study performed and how comprehensive it may be.

POLYSOMNOGRAM (PSG): A sophisticated instrumentation to record the body's various activities during sleep. It is the best method to diagnose sleep-related breathing disorders: measures and records the AHI, RDI, the brain waves and activity, heart rate, pulse rate, body movement, movement of eyes, length of sleep, sleep stages, number of arousals, number of apneic episodes, volume of nasal and oral airflow, loudness of snoring, unusual leg and arm movement, oxygen saturation in the blood, cardiovascular abnormalities during sleep, etc.

Home Sleep Study: due to advances in computer science and sleep technology, sleep study can now be performed by an ambulatory device at home where the patient feels more comfortable and can sleep without putting multiple testing electrodes around the face and body. This is a simple version of PSG and provides essential data: loudness of snoring, severity of sleep apnea (AHI RDI), blood oxygen saturation, pulse rate, body movement and position while sleeping, and identifies REM and Non-REM sleep stages etc.

Definition:

  • Apnea= cessation of breathing, during sleep for 10 seconds and more
  • Hypopnea= >50% decrease in airflow for 10 seconds or greater with a decrease in oxygen saturation of >4%, or an arousal
  • AHI (Apnea/Hypopnea Index) = apnea plus hypopnea per hour during sleep
  • RDI (Respiratory Disturbance Index) = AHI + snoring + RERA (Respiratory Effort Related Arousal) 
  • SaO2 scale= oxygen saturation in the blood.  >89% (nomal)  80-89% (moderate)  <80% (severe)
  • REM= rapid eye movement - dreaming stage of sleep
  • NREM = regular sleep stage of sleep

Self Testing
Sleep Disordered Breathing Screening:
Are you sleepy during the day? (driving, reading, sitting in a meeting) Yes No
Do you snore or have you ever been told that you snore? Yes No
Do you awake gasping or have pauses in your breathing while asleep? Yes No
Do you awake with headaches? Yes No
Do you have difficulty falling or staying asleep? Yes No
Do you feel un-rested despite a full night's sleep? Yes No
The Epworth Sleepiness Scale (ESS):

ESS is widely used to measure the subject's average sleep propensity across those different situations in daily life, particularly in patients with sleep-disordered breathing.

How likely are you to doze off or fall asleep during the day in the following situations, in contrast to just feeling tired? Use the following scale to choose the most appropriate number for each situation:

0 = would never doze, 1 = slight chance of dozing, 2 = moderate chance of dozing, 3 = high chance of dozing

Situation Chance of dozing
Sitting and reading 0 1 2 3
Watching T.V. 0 1 2 3
Sitting, inactive in a public place (meeting, theatre) 0 1 2 3
As a passenger in a car for an hour without a break 0 1 2 3
Lying down to rest in the afternoon when circumstances permit 0 1 2 3
Sitting and talking to someone 0 1 2 3
Witting quietly after lunch without alcohol 0 1 2 3
In a car, while stopped for a few minutes in the traffic 0 1 2 3
Total Score_______

* Total Score: 0-6 = normal; 7-12 = mild; 13-18 = moderate; 19 and over = severe. If your total score is 10 or more, snore and/or awake gasping for breath at night, you may have Sleep Breathing Disorders and suggested to have examination by a sleep physician.

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TMJ, Head & Neck Pain Center would love to meet you and your family and provide you with the Sleep Apnea & TMJ care you need to give you the well being you deserve!