Sleep apnea other diagnostic studies
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Overview
Sleep Apnea Other Diagnostic Tests
Polysomnogram (PSG)
- Full-night, attended, in-laboratory polysomnography is considered the gold-standard diagnostic test for OSA
- It involves monitoring the patient during a full night's sleep:
- Brain activity
- Eye movements
- Heart rate:*Blood pressure:*Amount of oxygen in the blood:*Air movement through the nose while breathing, snoring, and chest movements
- Split-night, attended, in-laboratory polysomnography
- This involves the diagnostic portion of the study performed during the first part of the night only
- Those patients who are diagnosed with OSA during the first part of the night and choose positive airway pressure therapy can have their positive airway pressure device titrated during the second part of the night
Home-Based Portable Monitor
- The portable monitor will record some of the same information as a PSG
Sleep Studies
Measure how well the patient sleeps and how the body responds to sleep problems
Oximetry, which may be performed overnight in a a patient's home, is an easier alternative to formal sleep study (polysomnography.
- In one study, normal overnight oximetry was very sensitive and so if normal, sleep apnea was unlikely.[1] In addition, home oximetry may be equally effect in guiding prescription for automatically self-adjusting continuous positive airway pressure.[2]
- Another study found that overnight oximetry, defining abnormal as 15 or more 4% desaturations/hour, was very specific, but not sensitive.[3]
- Sensitivty of overnight oximetry is improved by using a 3% desaturation in oxygen.[4] and lowering the ODI to 5 per hour.[5]
- Oximetry may identify some patients whose outcomes are not improved by adding polysomnography.[6]
References
- ↑ Sériès F, Marc I, Cormier Y, La Forge J (1993). "Utility of nocturnal home oximetry for case finding in patients with suspected sleep apnea hypopnea syndrome". Ann Intern Med. 119 (6): 449–53. PMID 8357109.
- ↑ Whitelaw WA, Brant RF, Flemons WW (2005). "Clinical usefulness of home oximetry compared with polysomnography for assessment of sleep apnea". Am J Respir Crit Care Med. 171 (2): 188–93. doi:10.1164/rccm.200310-1360OC. PMID 15486338. Review in: ACP J Club. 2005 Jul-Aug;143(1):21
- ↑ Ryan PJ, Hilton MF, Boldy DA, Evans A, Bradbury S, Sapiano S; et al. (1995). "Validation of British Thoracic Society guidelines for the diagnosis of the sleep apnoea/hypopnoea syndrome: can polysomnography be avoided?". Thorax. 50 (9): 972–5. PMC 1021311. PMID 8539678.
- ↑ Nigro CA, Dibur E, Rhodius E (2012). "Accuracy of the clinical parameters and oximetry to initiate CPAP in patients with suspected obstructive sleep apnea". Sleep Breath. 16 (4): 1073–9. doi:10.1007/s11325-011-0603-0. PMID 22009031.
- ↑ Douglas NJ, Thomas S, Jan MA (1992). "Clinical value of polysomnography". Lancet. 339 (8789): 347–50. PMID 1346422.
- ↑ Mulgrew AT, Fox N, Ayas NT, Ryan CF (2007). "Diagnosis and initial management of obstructive sleep apnea without polysomnography: a randomized validation study". Ann Intern Med. 146 (3): 157–66. PMID 17283346. Review in: Evid Based Med. 2007 Oct;12(5):148 Review in: ACP J Club. 2007 Sep-Oct;147(2):45