Sleep Apnoea

Sleep Apnoea: How to Diagnose

Positional Therapy , Sleep Disorders , Case Studies , Snoring

Diagnosing sleep apnoea is based on a person’s medical and family histories, a thorough physical exam and the results of a credible sleep study. If you exhibit symptoms of sleep apnoea, you should first consult with your primary care doctor to evaluate your symptoms. Based on the consultation, the doctor will then decide if you need further consult with a sleep specialist.

Doctors who diagnose, manage, and treat people with sleep disorders are called sleep specialists. It is usual for these doctors to be ear, nose, and throat (ENT) and lung specialists. However, with the proper training, other types of doctors can become sleep specialists too.

Medical and Family Histories

If you suspect you have a sleeping disorder, ask your partner or relative to observe you while you sleep. If you have obstructive sleep apnoea, episodes of breathlessness will readily show during sleep.

Before seeing a doctor, it may help if you keep a sleep diary for at least a week. You should write down the time you go to sleep, wake up and take short naps. You should also indicate how rested and alert you feel when you wake up in the morning: or how tired and sleepy you are during the day. Show the sleep diary to your doctor during your consult as this will greatly help his diagnosis.

During the consult, your doctor will ask questions about how you sleep and how you function (or not function) in the daytime. Since your doctor will ask how loud and often you snore, or make choking/gasping sounds while you sleep, it is best to ask your partner or relative (who observes you while you sleep) to write down such episodes.

If anyone in the family has symptoms of or has been diagnosed with sleep apnoea, tell your doctor.

PSG test

Tests for Sleep Apnoea

Your doctor will first do a physical examination to check your nose, mouth, and throat for large or extra tissues. Children with sleep apnoea usually have enlarged tonsils and this readily confirms sleep apnoea in them. Adults suspected of sleep apnoea will usually have an enlarged soft palate or uvula. The soft palate is the roof of your mouth while the uvula is the tissue that hangs from the middle of the back of your mouth.

Your doctor will next conduct sleep studies on you to measure how your body responds to sleep problems and whether you sleep well. These sleep studies will greatly help your doctor determine if you have a sleep disorder and its severity. These tests are the most accurate in diagnosing sleep apnoea.

Polysomnogram or Home-based Portable Monitor

Currently, there are two types of sleep tests done to determine sleep apnoea: a Polysomnogram and a home-based portable monitor.
Polysomnogram (PSG) is the most widely used sleep study to diagnose sleep apnoea. This sleep test records the activity of your brain, heart rate, eye movements and blood pressure.

A PSG will also indicate the oxygen level in your blood, chest movement, snoring, and the movement of air through your nose while you breathe. The chest movement will indicate whether you are trying or not to breathe.

PSG tests are done in sleep labs or sleep centres. The test is virtually painless as it will only entail you sleeping with sensors attached to your chest, face, scalp, fingers, and limbs. These sensors will transmit the pertinent details needed to diagnose sleep apnoea. The reading of the PSG result by a qualified doctor will determine if you have sleep apnoea, its severity and the best CPAP setting for the treatment and management of your sleep apnoea.

A split-night sleep study could be done as a further test if you have sleep apnoea. This study will entail you sleeping without a CPAP machine and sleeping with a CPAP machine. This test will help determine the right amount of air pressure and flow from the CPAP machine.

A home-based portable monitor will record the same information as a PSG. This can be done at home. You will be given instructions on how to do the test. The results will determine if you need a full PSG sleep study in a sleep lab.

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