Sleep apnea screening

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

Overview

Although there are is no mandatory screening for patients suspected with sleep apnea, there are some recommended guidelines. For patients with obstructive sleep apnea, screening questionnaires are useful for populations at risk for diurnal sleepiness. Regarding central sleep apnea, a continuous overnight ambulatory oximetry can help predict the prognosis in patients with CHF or cardiovascular disease.

Sleep Apnea Screening

For patients with obstructive sleep apnea:

• Screening questionnaires may be useful for high risk patients

• STOP questionnaire asks about the presence of loud snoring, apneas, excessive daytime sleepiness, and hypertension
• STOP-BANG questionnaire combines the STOP questionnaire questions and adds BMI, age, and neck circumference (increased sensitivity but decreased specificity compared to STOP questionnaire)

• Commercial drivers, operators of heavy equipment, pilots, and other populations at risk from diurnal sleepiness should with be screened with a history and physical exam

• If OSA is suspected, a sleep study should be performed

For patients with central sleep apnea:

• Some centers recommend using continuous overnight ambulatory oximetry in patients with CHF or cardiovascular disease

• A patient with heart failure and central sleep apnea or Cheyne-Stokes breathing normally means a poorer prognosis