Diagnosis of Sleep Apnea

For children

1. Polysomnography:  Though commonly used for diagnosis in children, PSG was not designed for the purpose.  As children have a different physiology and higher respiratory rates, machines designed for adults are not appropriate.

2. Esophageal pressure monitors:  To note the increased respiratory effort in children with upper airway resistance syndrome, esophageal pressure monitoring is essential. Polysomnography is not very useful in these conditions. A pressure probe kept in the esophagus measures frequent or extreme negative pressures that lead to disruption of their sleep.

3. Apnea-hypopnoea index and minimum oxygen saturation levels are taken as indicators to test the average number of apneas and hypopnoeas in an hour of sleep.

4. Video photography is used to record apnea events and night time awakening in children.

5. Nasopharyngoscopy provides information on the degree of obstruction in the nasal passage of the child.

6. Lateral neck radiography gives information about the size of the adenoids.

7. Pulse oximetry, is a screening tool for obstructive sleep apnea disorder. But greater accuracy cannot be obtained.

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For adults

1. Before going to the physician it is recommended to maintain a sleep diary recording how loud you snore, whether you wake up in sleep, whether you are experiencing difficult breathing (choking or gasping).

2. A sound-activated audio recorder is another instrument which can help in self-diagnosis.

3. Endoscopy of nose and throat can verify blockages.

4. X-rays or a CT scan of the head and neck can be obtained if necessary, to get a better picture.

5. The basic diagnosis in the doctors office and includes a general examination on the pattern of sleep, the activities of the person throughout the day and medical history. This information is obtained from the patient and his family.

6. Checking for any growth of extra tissues in mouth, nose and throat especially tonsils, uvula and soft palate.

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7. Polysomnogram: It is a painless sleep recording monitor which tests the breathing pattern in the night. It is mostly performed at sleep centers or laboratories in a hospital. It records the brain activity, eye movement, muscle activity, breathing and heart rate, amount of airflow in and out of the lungs when the body is at rest and the percentage of oxygen in the blood.  After recording these details, the number of times breathing is impaired during sleep is tailed and the severity is graded.

8. Multiple sleep latency test (MSLT): This test is performed to measure the speed at which a person falls asleep. In this test, several opportunities are given to the patient to fall asleep during the course of a day when they would normally be awake.

9. Oximetry: In this painless method a simple sleeve is inserted over one of the patient's fingers, to monitor and record oxygen levels throughout the night at home. During sleep, the oxygen level during apneas will drop and rise again as the person awakens. If the results are abnormal, polysomnography is done to reconfirm the diagnosis.

10. Electroencephalogram (EEG): This is used to monitor repeated awakenings in sleep. It can help diagnose apnea by checking the patient's brain waves.

The next article examines common questions asked in sleep apnea research

Sleep apnea diagnosis resources

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