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Diagnosis and Testing  

Doctors diagnose sleep apnea based on medical and family histories, a physical exam, and results from sleep studies. Usually, your primary care doctor evaluates your symptoms first. He or she then decides whether you need to see a sleep specialist.  Sleep specialists are doctors who diagnose and treat people who have sleep problems. Examples of such doctors include lung and nerve specialists and ear, nose, and throat specialists. Other types of doctors also can be sleep specialists.

Family History:  Your doctor will ask you and your family questions about how you sleep and how you function during the day. To help your doctor, consider keeping a sleep diary for 1 to 2 weeks. Write down how much you sleep each night, as well as how sleepy you feel throughout the day.

Snoring:  Your doctor also will want to know how loudly and often you snore or make gasping or choking sounds during sleep. Often you're not aware of such symptoms and must ask a family member or bed partner to report them.  Let your doctor know if anyone in your family has been diagnosed with sleep apnea or has had symptoms of the disorder. 
Many people aren't aware of their symptoms and aren't diagnosed.

Physical Exam:  Your doctor will check your mouth, nose, and throat for extra or large tissues. Adults who have sleep apnea may have an enlarged uvula (U-vu-luh) or soft palate. The uvula is the tissue that hangs from the middle of the back of your mouth. The soft palate is the roof of your mouth in the back of your throat.

Sleep Studies:  A sleep study is the most accurate test for diagnosing sleep apnea. It records what happens with your breathing while you sleep. There are different kinds of sleep studies. If your doctor suspects you have sleep apnea, he or she may recommend a polysomnogram (poly-SOM-no-gram; also called a PSG) or a home-based portable monitor. 
PSGs often are done at sleep centers or sleep labs. In some cases, doctors suggest using portable sleep monitors at home.

Polysomnogram:  A PSG is the most common sleep study for diagnosing sleep apnea. This test records:

  • Brain activity
  • Eye movement and other muscle activity
  • Breathing, heart rate, and blood pressure
  • How much air moves in and out of your lungs while you're sleeping
  • The amount of oxygen in your blood
A PSG is painless. You'll go to sleep as usual, except you'll have sensors on your scalp, face, chest, limbs, and finger. The staff at the sleep center will use the sensors to check on you throughout the night.

A sleep specialist reviews the results of your PSG to see whether you have sleep apnea and how severe it is. He or she will use the results to plan your treatment.

Home-Based Portable Monitor:  Your doctor may recommend a home-based sleep test with a portable monitor. The portable monitor will record some of the same information as a PSG. For example, it may record:
  • The amount of oxygen in your blood
  • How much air is moving through your nose while you breathe
  • Your heart rate
  • Chest movements that show whether you're making an effort to breathe
A sleep specialist may use the results from a home-based sleep test to help diagnose sleep apnea. He or she also may use the results to determine whether you need a full PSG study in a sleep center.

Interpretation:  Your doctor also may use a PSG to find the right setting for you on a CPAP (continuous positive airway pressure) machine. CPAP is the most common treatment for sleep apnea. A CPAP machine uses mild air pressure to keep your airway open while you sleep.

If your doctor thinks that you have sleep apnea, he or she may schedule a split-night sleep study. During the first half of the night, your sleep is checked without a CPAP machine. This will show whether you have sleep apnea and how severe it is.

If the PSG shows that you have sleep apnea, you may use a CPAP machine during the second half of the split-night study. During this time, the flow of air from the CPAP machine will be adjusted to find the setting that works best for you.
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