Snoring? Sleepy? When to Be Concerned?

Why is Sleep Apnea underdiagnosed?

Sleep apnea is underdiagnosed because the most common symptoms, like excessive daytime sleepiness or snoring, are undervalued by patients. People do not come to the doctor and complain about it.

Moreover, physicians’ busy schedules and limited appointment times often lead to a focus on the symptoms reported by patients, and insufficient attention is paid to the quality of sleep.

Identifying and recognizing risk factors can facilitate OSA suspicion during patient evaluations.

How to actively inquire about the possibility of Obstructive Sleep Apnea?

Once the possibility of OSA is considered, the next step is to ask patients about their symptoms. Questionnaires are simple yet valuable tools for this purpose. STOP and STOP-BANG are two common questionnaires that are used.

What is the STOP questionnaire?

1. Do you SNORE loudly (louder than talking or loud enough to be heard through closed doors)?
2. Do you often feel TIRED, fatigued, or sleepy during daytime?
3. Has anyone OBSERVED you stop breathing during your sleep?
4. Do you have or are you being treated for high blood PRESSURE?

What is the STOP-BANG questionnarie?

1. Do you SNORE loudly (louder than talking or loud enough to be heard through closed doors)?
2. Do you often feel TIRED, fatigued, or sleepy during daytime?
3. Has anyone OBSERVED you stop breathing during your sleep?
4. Do you have or are you being treated for high blood PRESSURE?
5. Obesity (BMI > 35 kg/m2)
6. Age (>50 years)
7. Neck size (>40 cm, or 16 inches)
8. Sex

What is the difference between the STOP and the STOP-BANG questionnaires?

The STOP-BANG questionnaire adds four quantitative and objective measures to the STOP questionnaire, by gathering more information about the patient.

Patients are classified as being at low, intermediate, or high risk for OSA.

What is the Epworth Sleepiness Scale?

The Epworth Sleepiness Scale (ESS) is a self-administered short questionnaire designed to assess daytime sleepiness. This basic test involves a self-assessment of how likely a person is to fall asleep in eight different situations. Doctors may use this test to help identify excessive daytime sleepiness.

Answering the questions only takes a few minutes and can be done on paper or electronically in a wide range of different settings, including at home. These questionnaires can be seamlessly integrated into routine patient appointments.

Who should be prioritized for diagnostic testing for OSA?

Patients with resistant hypertension, pulmonary hypertension, and recurrent atrial fibrillation following cardioversion/ablation should be prioritized for diagnostic testing for OSA.

Patients with other conditions, such as coronary artery disease or cerebrovascular disease, should also be referred to a sleep center if OSA is suspected on the basis of comprehensive sleep assessment.

OSA has also been associated with type 2 diabetes, metabolic syndrome, and asthma.

Is In-Home Sleep Testing a Viable Option?

Diagnosing OSA typically relies on overnight polysomnography in specialized sleep clinics, which is often associated with long waiting lists. The architecture of sleep is very complex. The test must be performed and read by a specialized team.

With 6 locations in Ohio, we offer fast scheduling and convenient service, including telehealth and video consultations. Columbus Sleep Consultants also offers in-home sleep testing.

Are there any advancements in the diagnosis of OSA and is it becoming more feasible?

In conclusion, the diagnosis of sleep apnea in primary care is becoming more feasible with advancements in diagnostic tools and technology. However, it is crucial for primary care physicians to exercise caution in cases in which the clinical presentation is not straightforward or when OSA is associated with comorbidities. Care management and clear boundaries are vital to ensure effective treatment and improve patient outcomes.

Gaining access to sleep study services and subsequent therapy, such as continuous positive airway pressure (CPAP), can be challenging. Thankfully, our team at Columbus Sleep Consultants is here to serve you and help you sleep and live better!

Contact Us Today if you have any questions or concerns or just need a second opinion!

—

To learn more about Obstructive Sleep Apnea or Sleep Disorders, or if you feel that you or someone you know may be suffering from it or having trouble sleeping, contact us at info@columbussleep.com or call us at 614-866-8200. We have 6 locations in Ohio to serve you!