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: 8/5/2014  

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.
Author(s) and Disclosures:
David Claman, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Christopher A. Klipstein, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.

One or more of the present or past ACP Smart Medicine physician editors worked on this module and had nothing to disclose: Davoren Chick, MD, FACP; Deborah Korenstein, MD, FACP; Marjorie Lazoff, MD, FACP; Richard Lynn, MD, FACP.

Related Content
Annals of Internal Medicine