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==Overview==
==Overview==
The diagnosis of sleep apnea is obtained by a polysomnogram or an oximeter. Other tests include and EEG, EMG, EOG, ECG, a nasal airflow sensor, and a snore microphone.
Other tests for sleep apnea include EEG, EMG, EOG, ECG, a nasal airflow sensor, and a snore microphone.


==Sleep Apnea Other Diagnostic Tests==
==Sleep Apnea Other Diagnostic Tests==


===Polysomnogram (PSG)<ref name="pmid9302726">{{cite journal| author=Chesson AL, Ferber RA, Fry JM, Grigg-Damberger M, Hartse KM, Hurwitz TD et al.| title=The indications for polysomnography and related procedures. | journal=Sleep | year= 1997 | volume= 20 | issue= 6 | pages= 423-87 | pmid=9302726 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9302726 }} </ref>===
A clinical practice guideline by the American College of Physicians<ref name="pmid25089864">{{cite journal| author=Qaseem A, Dallas P, Owens DK, Starkey M, Holty JE, Shekelle P et al.| title=Diagnosis of obstructive sleep apnea in adults: a clinical practice guideline from theAmerican College of Physicians. | journal=Ann Intern Med | year= 2014 | volume= 161 | issue= 3 | pages= 210-20 | pmid=25089864 | doi=10.7326/M12-3187 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25089864 }} </ref> and the American Academy of Sleep Medicine<ref name="pmid28162150">{{cite journal| author=Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K et al.| title=Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. | journal=J Clin Sleep Med | year= 2017 | volume= 13 | issue= 3 | pages= 479-504 | pmid=28162150 | doi=10.5664/jcsm.6506 | pmc=5337595 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28162150 }} </ref><ref name="pmid29183053">{{cite journal| author=Mokhlesi B, Cifu AS| title=Diagnostic Testing for Obstructive Sleep Apnea in Adults. | journal=JAMA | year= 2017 | volume= 318 | issue= 20 | pages= 2035-2036 | pmid=29183053 | doi=10.1001/jama.2017.16722 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29183053  }} </ref> address diagnosis.
*Also known as a sleep study
*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
 
===Oximetry<ref name="pmid9302726">{{cite journal| author=Chesson AL, Ferber RA, Fry JM, Grigg-Damberger M, Hartse KM, Hurwitz TD et al.| title=The indications for polysomnography and related procedures. | journal=Sleep | year= 1997 | volume= 20 | issue= 6 | pages= 423-87 | pmid=9302726 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9302726 }} </ref>===
* As known as a home-based portable monitor
*The portable monitor will record some of the same information as a PSG
*The results of this device can help determine whether to do a PSG


===Other tests===
===Other tests===
Line 34: Line 17:
*Nasal airflow sensor to record airflow
*Nasal airflow sensor to record airflow
*Snore microphone to record snoring activity
*Snore microphone to record snoring activity
===Home respiratory polygraphy===
Home respiratory polygraphy (HRP) or called home sleep apnea testing (HSAT), can be classified into:
* Level 2 (L2), which include airflow, EEG, EOG, EMG, ECG/HR, effort SaO2
* Level 3 (L3), which include airflow, thoracoabdominal bands, body position, electrocardiography, and oxygen saturation
* Level 4 (L4), which added oxygen saturation and maybe heart rate
[[Randomized controlled trial]]s have compared the impact of using versus portable monitors that can be used at home:
* Corral found no significant difference.<ref name="pmid28636405">{{cite journal| author=Corral J, Sánchez-Quiroga MÁ, Carmona-Bernal C, Sánchez-Armengol Á, de la Torre AS, Durán-Cantolla J et al.| title=Conventional Polysomnography Is Not Necessary for the Management of Most Patients with Suspected Obstructive Sleep Apnea. Noninferiority, Randomized Controlled Trial. | journal=Am J Respir Crit Care Med | year= 2017 | volume= 196 | issue= 9 | pages= 1181-1190 | pmid=28636405 | doi=10.1164/rccm.201612-2497OC | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28636405  }} </ref>.
* Chai-Coetzer found no difference using L3 channels but inconclusive results with L4 monitoring (which just included oximetry and heart rate)<ref name="pmid28114683">{{cite journal| author=Chai-Coetzer CL, Antic NA, Hamilton GS, McArdle N, Wong K, Yee BJ et al.| title=Physician Decision Making and Clinical Outcomes With Laboratory Polysomnography or Limited-Channel Sleep Studies for Obstructive Sleep Apnea: A Randomized Trial. | journal=Ann Intern Med | year= 2017 | volume= 166 | issue= 5 | pages= 332-340 | pmid=28114683 | doi=10.7326/M16-1301 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28114683  }} </ref>.
* Whitelaw found no significant difference.<ref name="pmid15486338">{{cite journal| author=Whitelaw WA, Brant RF, Flemons WW| title=Clinical usefulness of home oximetry compared with polysomnography for assessment of sleep apnea. | journal=Am J Respir Crit Care Med | year= 2005 | volume= 171| issue= 2 | pages= 188-93 | pmid=15486338 | doi=10.1164/rccm.200310-1360OC | pmc= |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15486338  }} [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15989309 Review in: ACP J Club. 2005 Jul-Aug;143(1):21]</ref>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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[[Category:Sleep disorders]]
[[Category:Cardiology]]
[[Category:Medical conditions related to obesity]]
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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

Other tests for sleep apnea include EEG, EMG, EOG, ECG, a nasal airflow sensor, and a snore microphone.

Sleep Apnea Other Diagnostic Tests

A clinical practice guideline by the American College of Physicians[1] and the American Academy of Sleep Medicine[2][3] address diagnosis.

Other tests

  • EEG (electroencephalogram) to measure and record brain wave activity
  • EMG (electromyogram) to record muscle activity to determine REM stage sleep
  • EOG (electro-oculogram) to record eye movements to determine REM stage sleep
  • ECG (electrocardiogram) to record heart rate and rhythm.
  • Nasal airflow sensor to record airflow
  • Snore microphone to record snoring activity

Home respiratory polygraphy

Home respiratory polygraphy (HRP) or called home sleep apnea testing (HSAT), can be classified into:

  • Level 2 (L2), which include airflow, EEG, EOG, EMG, ECG/HR, effort SaO2
  • Level 3 (L3), which include airflow, thoracoabdominal bands, body position, electrocardiography, and oxygen saturation
  • Level 4 (L4), which added oxygen saturation and maybe heart rate


Randomized controlled trials have compared the impact of using versus portable monitors that can be used at home:

  • Corral found no significant difference.[4].
  • Chai-Coetzer found no difference using L3 channels but inconclusive results with L4 monitoring (which just included oximetry and heart rate)[5].
  • Whitelaw found no significant difference.[6]

References

  1. ↑ Qaseem A, Dallas P, Owens DK, Starkey M, Holty JE, Shekelle P; et al. (2014). "Diagnosis of obstructive sleep apnea in adults: a clinical practice guideline from theAmerican College of Physicians". Ann Intern Med. 161 (3): 210–20. doi:10.7326/M12-3187. PMID 25089864.
  2. ↑ Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K; et al. (2017). "Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline". J Clin Sleep Med. 13 (3): 479–504. doi:10.5664/jcsm.6506. PMC 5337595. PMID 28162150.
  3. ↑ Mokhlesi B, Cifu AS (2017). "Diagnostic Testing for Obstructive Sleep Apnea in Adults". JAMA. 318 (20): 2035–2036. doi:10.1001/jama.2017.16722. PMID 29183053.
  4. ↑ Corral J, Sánchez-Quiroga MÁ, Carmona-Bernal C, Sánchez-Armengol Á, de la Torre AS, Durán-Cantolla J; et al. (2017). "Conventional Polysomnography Is Not Necessary for the Management of Most Patients with Suspected Obstructive Sleep Apnea. Noninferiority, Randomized Controlled Trial". Am J Respir Crit Care Med. 196 (9): 1181–1190. doi:10.1164/rccm.201612-2497OC. PMID 28636405.
  5. ↑ Chai-Coetzer CL, Antic NA, Hamilton GS, McArdle N, Wong K, Yee BJ; et al. (2017). "Physician Decision Making and Clinical Outcomes With Laboratory Polysomnography or Limited-Channel Sleep Studies for Obstructive Sleep Apnea: A Randomized Trial". Ann Intern Med. 166 (5): 332–340. doi:10.7326/M16-1301. PMID 28114683.
  6. ↑ 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

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