Diagnosis

Patients can be easily evaluated for their risk of sleep apnea using 5 Simple Questions.

Sleep apnea is characterized by recurring episodes of apneas and hypopneas.

  • Apnea: complete occlusion of the airway and subsequent cessation of airflow for at least 10 seconds.
  • Hypopneas: partial occlusion of the airway that results in a 25-50% reduction in airflow and a 3-4% reduction in oxygen saturation.

The severity of disease is measured by the Apnea/Hypopnea Index (AHI), the number of apneas and hypopneas per hour of sleep, which is used to qualify the patient for therapy.

Clinical Evaluation for Sleep Apnea

Initial evaluation of patients may be done using 5 Simple Questions.

More comprehensive screening may include the Berlin Questionnaire.

Diagnosing Sleep Apnea

Patients may be tested for sleep apnea in a sleep center or at home.

Sleep Centers

  • Sleep centers use polysomnography in an attended study. Monitored channels may include EEG, EOG, EMG, ECG, airflow, respiratory effort, oximetry, and leg movements.
  • Sleep studies and continuous positive airway pressure (CPAP) titration may be done over two nights or in a single evening “split-night” study.
  • Titration establishes the pressure required for optimal therapy on CPAP devices. Automatic positive airway pressure (APAP) devices automatically deliver the lowest pressure required at any given time and adapt as the patient’s needs change over the course of a night and over time.

Home Testing

Home sleep testing enables patients to be diagnosed for sleep apnea after an unattended study using a device that monitors a subset of the parameters recorded by the sleep center. This test can be managed by the sleep center, a sleep physician, or any physician who offers the service in their practice.

Home testing is an approved method for diagnosing sleep apnea, and the Centers for Medicare and Medicaid Services (CMS) has recently released a Decision Memo related to reimbursement for home testing. The CMS Memo states that:

CPAP for adults is covered when diagnosed using a clinical evaluation and a positive:

Learn more about simple home sleep testing options for diagnosing.

ResMed’s ApneaLink™ Plus, a Type III device, is a simple, cost-effective 4-channel sleep diagnostic device that can be used for home testing.