Guidelines Issued on Diagnosing Obstructive Sleep Apnea — Physician’s First Watch
Guidelines Issued on Diagnosing Obstructive Sleep Apnea
By Amy Orciari Herman
The American Academy of Sleep Medicine has issued guidelines on diagnosing obstructive sleep apnea (OSA) in adults.
Among the recommendations with a "strong" rating, published in the Journal of Clinical Sleep Medicine:
Polysomnography or home testing with a "technically adequate device" should be used for diagnosis in uncomplicated adults with symptoms suggesting an increased risk for moderate-to-severe OSA (e.g., excessive daytime sleepiness plus two or more of the following: frequent loud snoring, witnessed apnea or gasping or choking, or hypertension). For home testing, at least 4 hours of oximetry and flow data should be obtained.
If home testing yields negative or inconclusive results, or is not technically adequate, polysomnography should be used.
Polysomnography is preferred over home testing for patients with severe cardiorespiratory disease, possible respiratory muscle weakness, hypoventilation while awake, potential sleep-related hypoventilation, chronic opioid use, or history of stroke or severe insomnia.
Clinical tools, questionnaires, or prediction algorithms shouldn't be used without polysomnography or home testing.