As you may already know, sleep apnea occurs when a person’s breathing temporarily stops during sleep. Obvious symptoms of sleep apnea such as loud snoring can indicate the possibility of sleep apnea -- but how is officially diagnosed, and how is it treated? Do more severe cases require surgery, or are there more comfortable remedies available?
How Sleep Apnea is Diagnosed
At the beginning, sleep apnea is diagnosed like any classic medical problem: a physical exam with a general practitioner or ENT specialist. After the initial examination, some specialized techniques will be used to determine the likelihood of sleep apnea.
- Measurement of neck size (a measurement of 17.5 inches or greater can increase chances of sleep apnea)
- Examination of the mouth to check the size of the tonsils, soft palate, or uvula
- Examining the nose to check for deviated septum
- Jaw size (with short jaws, the tongue sometimes falls backward, which can contribute to sleep apnea)
- Diagnostic laryngoscopy, to see if the palate and larynx collapses during breathing
Other factors doctors will check for include cardiac issues, diabetes, and obesity. Gender also plays a role in sleep apnea -- men have the condition at five times the rate of women.
Together, these factors contribute to what is known as the EPWORTH Scale -- a series of ten to thirty questions, which are then scored. The final rating indicates the likelihood of the patient having sleep apnea.
Based upon the results of the EPWORTH Scale, your doctor will determine if a sleep study is required. The patient generally has two options:
- A study held in a sleep center where observers monitor heart rate, chest excursion, brain waves, saturation of blood oxygen, cardiac rhythm, and air flow through the nose.
- A home sleep study via take-home kit. The patient is usually instructed on how to use the kit by a doctor.
Over the past few years, home sleep studies have improved dramatically in terms of accuracy. Unless a patient has a problematic issue, many insurance companies are likely to require a home sleep study before a sleep center study. This is good news for the patient, as home sleep studies tend to be less expensive and more comfortable.
Sleep Apnea Treatment Options
Once completed, the sleep study will deliver an apnea index (AHI), indicating the number of apnea episodes per number of hours slept. This result will be rated as mild, moderate or severe.
If the result is mild, and the patient has problems with obesity, a weight loss program may help address sleep apnea. While a patient addresses their weight loss, or if they are not obese, then a CPAP mask, used to keep the airway open, is often suggested. A CPAP mask is not a cure, nor is it always the end treatment, but it is encouraged as an initial step to see if it makes a difference. Depending on the results from the CPAP treatment, other options may include straightening of the septum, removal of the tonsils, trimming some palate tissue (UPPP Procedure) or application of an oral appliance to push the jaw forward. Your physician would determine if you would see relief from any of these surgeries based on your current condition.