Sleep apnea diagnostic criteria: Difference between revisions

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Latest revision as of 00:12, 30 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saarah T. Alkhairy, M.D.; Kiran Singh, M.D. [2]

Overview

The diagnosis of sleep apnea is listed in the DSM-V guidelines using either either the Apnea Hyponea Index (AHI) or the Respiratory Disturbance Index (RDI).

Sleep Apnea Diagnostic Criteria

The common indices used to assess breathing are Apnea Hyponea Index (AHI) and Respiratory Disturbance Index (RDI)

AHI is the number of apneas or hypopneas recorded during the study per hour of sleep
RDI is the average number of respiratory disturbances (obstructive apneas, hypopneas, and respiratory event-related arousals [RERAs]) per hour

None/Minimal OSA: AHI = 0-4
Mild OSA: AHI = 5-14: Patients may either be asymptomatic or may complain of sleepiness when they are sedentary. The daytime sleepiness often does not impair the patients' quality of life.
Moderate OSA: AHI = 15-29: Patients are usually symptomatic.
Severe OSA: AHI ≥ 30: Patients' symptoms are severe enough to interfere with daily activities. They may fall asleep during activities that require attention (e.g. driving)

“

DSM-V Diagnostic Criteria for Obstructive Sleep Apnea

At least one of the following criteria must be met:^[1]:

1. Evidence by polysomnography of AHI or RDI ≥ 5 and ≤ 14 events per hour of sleep PLUS either of the following sleep symptoms:

Nocturnal breathing disturbances: any of snoring, snorting/gasping, or breathing pauses during sleep, OR
Any of daytime sleepiness, fatigue, or unrefreshing sleep despite sufficient sleep that is not better explained by any other disorder (including other sleep disorders)

OR
2. Evidence by polysomnography of either AHI or RDI ≥ 15 events per hour of sleep regardless of presence/absence of clinical manifestations

DSM-V Diagnostic Criteria for Central Sleep Apnea

Both criteria must be met:^[1]:

1. Evidence by polysomnography of AHI or RDI greater than or equal to 5 events per hour of sleep
AND
2. The disorder is not better explained by another current sleep disorder

”

References

↑ ^1.0 ^1.1 Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association. 2013. ISBN 0890425558.

Template:WikiDoc Sources

[DSMV-1] 1.0 ^1.1 Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association. 2013. ISBN 0890425558.

[1]

@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Sleep apnea}}
-{{CMG}}; {{AE}} {{JH}}
+{{CMG}} {{AE}} Saarah T. Alkhairy, M.D.; {{KS}}
 ==Overview==
-The American Academy of Sleep Medicine published a diagnostic manual guidelines.<ref name="pmid23066376">{{cite journal| author=Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK et al.| title=Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. | journal=J Clin Sleep Med | year= 2012 | volume= 8 | issue= 5 | pages= 597-619 | pmid=23066376 | doi=10.5664/jcsm.2172 | pmc=PMC3459210 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23066376  }} </ref><ref name="pmid19960649">{{cite journal| author=Epstein LJ, Kristo D, Strollo PJ, Friedman N, Malhotra A, Patil SP et al.| title=Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. | journal=J Clin Sleep Med | year= 2009 | volume= 5 | issue= 3 | pages= 263-76 | pmid=19960649 | doi= | pmc=PMC2699173 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19960649}}</ref>
+The diagnosis of sleep apnea is listed in the DSM-V guidelines using either either the Apnea Hyponea Index (AHI) or the Respiratory Disturbance Index (RDI).
+==Sleep Apnea Diagnostic Criteria==
+The common indices used to assess breathing are Apnea Hyponea Index (AHI) and Respiratory Disturbance Index (RDI)
+*AHI is the number of apneas or hypopneas recorded during the study per hour of sleep
+*RDI is the average number of respiratory disturbances (obstructive apneas, hypopneas, and respiratory event-related arousals [RERAs]) per hour
+::*'''None/Minimal OSA''': AHI = 0-4
+::*'''Mild OSA''': AHI = 5-14: Patients may either be asymptomatic or may complain of sleepiness when they are sedentary. The daytime sleepiness often does not impair the patients' quality of life.
+::*'''Moderate OSA''': AHI = 15-29: Patients are usually symptomatic.
+::*'''Severe OSA''': AHI ≥ 30: Patients' symptoms are severe enough to interfere with daily activities. They may fall asleep during activities that require attention (e.g. driving)
-==Diagnosis Criteria==
-===DSM-V Diagnostic Criteria for Central Sleep Apnea<ref name=DSMV>{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558 }}</ref>===
 {{cquote|
+===DSM-V Diagnostic Criteria for Obstructive Sleep Apnea===
+At least one of the following criteria must be met:<ref name=DSMV>{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558 }}</ref>:
-A. Evidence by polysomnography of five or more central apneas per hour of sleep.
+. Evidence by [[polysomnography]] of AHI or RDI ≥ 5 and ≤ 14 events per hour of sleep '''PLUS''' either of the following sleep symptoms:
+*[[Nocturnal]] breathing disturbances: any of snoring, snorting/gasping, or breathing pauses during sleep, '''OR'''<br>
-'''''AND'''''
+*Any of daytime sleepiness, fatigue, or unrefreshing sleep despite sufficient sleep that is not better explained by any other disorder (including other sleep disorders)<br>
+'''OR'''<br>
-B. The disorder is not better explained by another current sleep disorder.
+. Evidence by [[polysomnography]] of either AHI or RDI ≥ 15 events per hour of sleep regardless of presence/absence of clinical manifestations
-Specify whether:
-* Idiopathic central sleep apnea: Characterized by repeated episodes of [[apnea]]s and [[hypopnea]]s during sleep caused by variability in respiratory effort but without evidence of airway obstruction.
-* Cheyne-Stokes breathing: A pattern of periodic crescendo-decrescendo variation in tidal volume that results in central apneas and hypopneas at a frequency of at least five events per hour, accompanied by frequent arousal.
-* Central sleep apnea comorbid with opioid use: The pathogenesis of this subtype is attributed to the effects of [[opioids]] on the respiratory rhythm generators in the [[medulla]] as well as the differential effects on [[hypoxic]] versus hypercapnic respiratory drive.
+===DSM-V Diagnostic Criteria for Central Sleep Apnea===
+Both criteria must be met:<ref name=DSMV>{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558 }}</ref>:
-Specify current severity:
+. Evidence by [[polysomnography]] of AHI or RDI greater than or equal to 5 events per hour of sleep<br>
-: Severity of central sleep apnea is graded according to the frequency of the breathing disturbances as well as the extent of associated oxygen desaturation and sleep fragmentation that occur as a consequence of repetitive respiratory disturbances.
+'''AND'''<br>
+. The disorder is not better explained by another current sleep disorder
 }}
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