Diagnosis
The diagnosis of obstructive sleep apnea includes a medical history, signs and symptoms, a medical exam and overnight testing.
A common and faster approach for the family doctor is to order a sleep apnea screening test. This is done using a portable device at patient’s home. If the screening results are positive for sleep apnea and there are no other complicating conditions, the physician may order a trial of CPAP (Continuous Positive Airway Pressure) therapy.
Alternately, the family physician may refer patients to a sleep specialist that would determine the appropriate level of sleep testing, the severity of the condition, and a treatment plan.
Level I testing (Polysomnography)
Polysomnography or Level I testing is the standard overnight full sleep study in an attended sleep clinic. This level of testing gives the most complete clinical picture and is most helpful in diagnosis and follow up during the treatment.
Polysomnography recording showing various channels and data collection.
Level III testing (Portable OSA screening device)
Level III testing is a more accessible procedure that involves a portable screening device designed for home sleep studies.
Patient sleeping with a portable OSA screening device.
Level III testing provides respiratory, cardiac, body position and snoring recording but it does not usually offer wake or sleep state staging. As technology and clinical knowledge gets better, nowadays we can get a more accurate clinical picture with this level of testing.
There are a variety of Level III devices in the market with comparable quality recording. The study is usually scored by a sleep technologist and ideally interpreted by a sleep specialist or family doctor.
- mild, with an Apnea/Hypopnea Index of 5-15
- moderate, with an AHI of 15-30
- severe, with an AHI > 30