Browse
Topics & Collections
Search for a specific
disease or term
—  or  —
Learn more about ACP Smart Medicine

Dynamed

X
This content was provided by DynaMed (dynamed.ebscohost.com). For more information click here.
Last Updated: 9/30/2013  

Obstructive Sleep Apnea

Diagnosis
  • Ask patients and their sleeping partner and/or family members about symptoms including snoring, apneas, awakenings due to gasping or choking, daytime sleepiness, fatigue, poor concentration, nasal congestion, weight gain, and morning headaches.

  • Obtain a sleep study using formal in-laboratory polysomnography for the most accurate diagnosis of OSA.

  • Use the results of the sleep study to determine the severity of OSA.

    • Define mild OSA as an AHI (or RDI) between 5 and 15. Patients with mild OSA often report sleepiness when they are sedentary and under-stimulated.

    • Define moderate OSA as an AHI (or RDI) between 15 and 30. Patients with moderate OSA often report sleepiness more often throughout the day.

    • Define severe OSA as an AHI (or RDI) more than 30. Patients with severe OSA often have sleepiness that interferes significantly with daily activities.

Therapy
  • Treat the majority of patients with OSA with CPAP.

  • Consider oral appliances for patients who are unable to adhere to CPAP.

  • Consider surgical treatment for appropriate patients.

  • Consider a trial of modafinil for patients with residual excessive daytime sleepiness who have no other identifiable cause for their sleepiness.

DOI: 10.7326/d351
The information included herein should never be used as a substitute for clinical judgment and does not represent an official position of ACP.
Disclosures:
David Claman, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Christopher A. Klipstein, MD University of North Carolina School of Medicine
Chapel Hill, NC
has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Deborah Korenstein, MD, FACP, Editor in Chief, ACP Smart Medicine, has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. Richard B. Lynn, MD, FACP, Editor, ACP Smart Medicine, has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
Related Content
Annals of Internal Medicine