Sleep apnea differential diagnosis: Difference between revisions
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
{| {{table}} | |||
| align="center" style="background:#f0f0f0;"|'''Disease/Condition''' | |||
| align="center" style="background:#f0f0f0;"|'''Differentiating Signs/Symptoms''' | |||
| align="center" style="background:#f0f0f0;"|'''Differentiating Tests''' | |||
|- | |||
| Cheyne-Stokes respiration (CSB)||Recurrent episodes of apnea with absence of respiratory effort; CSB is associated with cerebrovascular disease, CHF, or renal failure ||In CSB, a crescendo-decrescendo change in breathing amplitude interpersed by episodes of central sleep apnea or hypoapnea would be seen | |||
|- | |||
| Narcolepsy||Level of sleepiness in narcolepsy may be higher in Epworth Sleepiness Scale; may have cataplexy, hypnagogic hallucincations, and sleep paralysis||A polysomnography should be performed to rule out OSA; a multiple sleep latency test (MLST) can assess for naroclepsy | |||
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| Insufficient sleep||Difficult to differentiate clinically||A polysomnography should be performed to rule out OSA; a sleep diary should used | |||
|- | |||
| Inadequate sleep hygiene||Irregular sleep schedule with frequent napping; frequent use of alcohol, nicotine, and caffeine; poor bedroom environment||A polysomnography should be performed to rule out OSA; diagnosis is usually clinical | |||
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| Periodic limb movement disorder||Patients describe an urge to move legs due to discomfort during periods of inactivity (including sleep); patients have excessive sleepiness||A polysomnography should demonstrate limb movements and rule out OSA | |||
|- | |||
| Nocturnal gastroesphageal reflux||Results in nocturnal restlessness, choking episodes during sleep, frequent awakening, and labored breathing||A polysomnography should be performed to rule out OSA | |||
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| Nocturnal asthma||Can present with nocturnal choking, gasping, coughing, or shortness of breath||A polysomnography should be performed to rule out OSA; PULMONARY function tests can be performed | |||
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| Primary snoring||More common than OSA||A polysomnography should be performed to rule out OSA | |||
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| Nocturnal panic attacks||Can present with nocturnal choking, gasping, coughing, or shortness of breath||A polysomnography should be performed to rule out OSA; a psychiatric history should be performed | |||
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| Congestive heart failure||Can present with nocturnal choking, gasping, coughing, or shortness of breath||A polysomnography should be performed to rule out OSA; EKG, chest x-ray, blood tests, stress testing, and cardiac catheterization can be performed | |||
|- | |||
| Sleep-related laryngospasm||Can present with nocturnal choking, gasping, coughing, or shortness of breath||A polysomnography should be performed to rule out OSA | |||
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| Chronic fatigue syndrome||Daytme fatigue is the only complaint||A polysomnography should be performed to rule out OSA | |||
|- | |||
| Depression||Can present with fatigue and feelings of hopelessness||A polysomnography should be performed to rule out OSA; a psychiatric history should be performed | |||
|- | |||
| Pseudocentral sleep apnea||These patients with diaphragmatic paralysis depend on accessory muscles during breathing and may have apnea during REM sleep (sleep apnea is mostly observed during non-REM sleep); history of neuromuscular disease||A polysomnography should be performed to rule out OSA; various neuromuscular disease tests can be performed | |||
|} | |||
==References== | ==References== | ||
Revision as of 14:09, 6 July 2015
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Sleep apnea differential diagnosis On the Web |
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Risk calculators and risk factors for Sleep apnea differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2]
Overview
Sleep must be differentiated from other diseases that cause loud snoring, fatigue, or daytime sleepiness.
Differential Diagnosis
| Disease/Condition | Differentiating Signs/Symptoms | Differentiating Tests |
| Cheyne-Stokes respiration (CSB) | Recurrent episodes of apnea with absence of respiratory effort; CSB is associated with cerebrovascular disease, CHF, or renal failure | In CSB, a crescendo-decrescendo change in breathing amplitude interpersed by episodes of central sleep apnea or hypoapnea would be seen |
| Narcolepsy | Level of sleepiness in narcolepsy may be higher in Epworth Sleepiness Scale; may have cataplexy, hypnagogic hallucincations, and sleep paralysis | A polysomnography should be performed to rule out OSA; a multiple sleep latency test (MLST) can assess for naroclepsy |
| Insufficient sleep | Difficult to differentiate clinically | A polysomnography should be performed to rule out OSA; a sleep diary should used |
| Inadequate sleep hygiene | Irregular sleep schedule with frequent napping; frequent use of alcohol, nicotine, and caffeine; poor bedroom environment | A polysomnography should be performed to rule out OSA; diagnosis is usually clinical |
| Periodic limb movement disorder | Patients describe an urge to move legs due to discomfort during periods of inactivity (including sleep); patients have excessive sleepiness | A polysomnography should demonstrate limb movements and rule out OSA |
| Nocturnal gastroesphageal reflux | Results in nocturnal restlessness, choking episodes during sleep, frequent awakening, and labored breathing | A polysomnography should be performed to rule out OSA |
| Nocturnal asthma | Can present with nocturnal choking, gasping, coughing, or shortness of breath | A polysomnography should be performed to rule out OSA; PULMONARY function tests can be performed |
| Primary snoring | More common than OSA | A polysomnography should be performed to rule out OSA |
| Nocturnal panic attacks | Can present with nocturnal choking, gasping, coughing, or shortness of breath | A polysomnography should be performed to rule out OSA; a psychiatric history should be performed |
| Congestive heart failure | Can present with nocturnal choking, gasping, coughing, or shortness of breath | A polysomnography should be performed to rule out OSA; EKG, chest x-ray, blood tests, stress testing, and cardiac catheterization can be performed |
| Sleep-related laryngospasm | Can present with nocturnal choking, gasping, coughing, or shortness of breath | A polysomnography should be performed to rule out OSA |
| Chronic fatigue syndrome | Daytme fatigue is the only complaint | A polysomnography should be performed to rule out OSA |
| Depression | Can present with fatigue and feelings of hopelessness | A polysomnography should be performed to rule out OSA; a psychiatric history should be performed |
| Pseudocentral sleep apnea | These patients with diaphragmatic paralysis depend on accessory muscles during breathing and may have apnea during REM sleep (sleep apnea is mostly observed during non-REM sleep); history of neuromuscular disease | A polysomnography should be performed to rule out OSA; various neuromuscular disease tests can be performed |