Diagnosis of Sleep Apnea
If your doctor suspects that you have sleep apnea, you will need an exam of your mouth, nose, throat, and neck to make sure that there aren't any problems with those tissues or structures.You will be asked about your sleep habits, such as whether you snore and if your bed partner witnesses that you stop breathing. You will also be asked about daytime sleepiness, fatigue, and if you easily fall asleep. A screening form may be completed, such as the Epworth Sleepiness Scale (ESS). There are two tests that can help in the diagnosis of sleep apnea: the polysomnogram and the multiple sleep latency test. A sleep specialist usually conducts both of these tests in an overnight sleep laboratory.
Polysomnogram Test(Sleep Study)For this test, you spend the night in a sleep center. Tiny electrodes are attached to various areas of your body in order to closely monitor your heart rate, eye movements, brain waves, and muscle activity throughout the night. Monitors also record your pulse rate, information about your breathing, changes in the concentration of oxygen in your blood, and your body position. An electrocardiogram (EKG) keeps track of whether you have any changes in your heart’s rhythm during sleep. The number of apnea events is recorded.This test can sometimes be performed at home. If you have obstructive sleep apnea, you may have the same test again, while wearing a face mask that provides positive pressure. This is called continuous positive airway pressure (CPAP). This mask is supposed to prevent the collapse of your airway and maintain your breathing during the night. At times, evaluation with CPAP can occur during the second half of the night after evaluation without CPAP. This is called a split-night study.
Multiple Sleep Latency TestThis test is usually done the day after the polysomnogram. With the same set of electrodes still attached, you are asked to take a series of 20-minute naps, every two hours throughout the day. The electrodes provide information about how quickly you fall asleep and how quickly you reach various levels of sleep, particularly the level called rapid eye movement (REM) sleep. This test can help determine your level of daytime sleepiness due to sleep apnea. If you fall asleep in five or fewer minutes, it may be a sign of extreme sleepiness due to sleep apnea. This test is most often performed to evaluate for other sleep disorders such as narcolepsy. It is often not necessary when evaluating for sleep apnea.
Other TestsIf you’re suspected of having central sleep apnea, you may need a variety of other tests to diagnose an underlying medical condition. Your doctor will have to determine what other symptoms you have and use these symptoms to determine which further studies may be needed.Possible other tests include:
- Blood tests
- MRI or CT scans of your brain
- Electroencephalogram (EEG) studies—brain wave studies
- Electromyogram (EMG) studies—studies of electrical conduction along nerves
- Nocturnal pulse oximetry
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