How is obstructive sleep apnea diagnosed?
The first clinical indicator of obstructive
sleep apnea, loud snoring, is frequently reported by the patient’s sleeping
part-ner. Definitive diagnosis is obtained by sleep studies, which look for
apnea and hypopnea. Apnea is the total cessation of gas flow through the
airway, despite attempts to breathe. Hypopnea is reduction of gas flow through
the airway while breathing. Diagnostic criteria generally include five or more
episodes of apnea lasting 10 seconds or more, associated with a 4% decrease in
oxygen saturation by pulse oximetry (SpO2). Other criteria include
15 or more episodes of hypop-nea attaining at least a 50% decrease in flow
lasting 10 sec-onds or longer, and associated with a 4% decrease in SpO2.
Although most patients with obstructive sleep
apnea are morbidly obese, many lean patients suffer from this problem. It tends
to occur in middle-aged and elder adults. Obstructive sleep apnea may be
exacerbated by sedatives, hypnotics, alcohol, or muscle relaxants. Young
patients with craniofacial abnormalities sometimes manifest obstructive sleep
apnea, also.
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