we conducted a structured literature search of medline and the cochrane database of systematic reviews for “obstructive sleep apnea” or “sleep apnea,” in addition to targeted searches on pubmed. sleep specialist assessment and polysomnography is particularly important when patients are at risk of central sleep apnea or hypoventilation; these conditions are suggested by the presence of neurologic disease, neuromuscular disease, congestive heart failure, severe lung disease, opioid use or obesity with a serum bicarbonate level of more than 27 mmol/l.50 polysomnography is also indicated for the evaluation of suspected sleep disorders other than osa or after nondiagnostic home sleep apnea testing among patients with a high pretest probability of osa.20 several types of home sleep apnea testing are in clinical use.
symptomatic patients with osa should undergo a trial of treatment with continuous positive airway pressure.4,9 continuous positive airway pressure reduces ahi and sleepiness.4 although previous meta-analyses have not been definitive, the findings of some recent well-designed rcts support that the use of continuous positive airway pressure improves quality of life.4–6 there is ongoing research to establish the benefits of osa treatment on associated morbidity. about 5% of patients have persistent sleepiness despite exclusion of these causes and may benefit from drugs to promote wakefulness.91 there is emerging interest in personalized approaches to the diagnosis and management of osa. contributors: all of the authors contributed subtantially to the conception and design of the work, revised it critically for important intellectual content, gave final approval of the version to be published and agreed to be accountable for all aspects of the work.
home sleep tests. your doctor might provide you with simplified tests to be used at home to diagnose sleep apnea. these tests usually measure tests to detect obstructive sleep apnea include: polysomnography. during this sleep study, you’re hooked up to equipment that monitors your if you have symptoms of sleep apnea, your doctor may ask you to have a sleep apnea test, called a polysomnogram (psg). this may be done in a, .
screening questionnaires can be used to assess for sleep apnea, although their accuracy is limited. the diagnostic standard for obstructive a definitive sleep apnea diagnosis can be made only with a sleep study conducted during a visit to a sleep lab, usually overnight, or a home study performed the gold standard for diagnosis of osa is attended polysomnography (level i study), which involves collection of seven or more data channels, including, .
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