Sleep Apnea Diagnosis

Sleep Apnea Diagnosis

Based on your signs and symptoms your family doctor or general practitioner will refer you to a sleep specialist for further evaluation.

The sleep physician may do a physical examination to check for any abnormalities at the back of your throat and mouth and check your blood pressure.

To further assess your symptoms, the physician may prescribe an overnight monitoring (sleep study) of your breathing and sleep patterns to detect if you have obstructive sleep apnea. Usually there are two sleep studies, the first to determine if you have obstructive sleep apnea, and second sleep study to determine a customized therapy plan geared to your specific condition.

After both sleep studies are done, the sleep physician will assess the results and provide you with a treatment plan that would be the most effective to treat your sleep apnea during your follow up.

Sleep Study
The overnight sleep studies are done at a ministry regulated sleep clinic, in a private room. Sleep technicians will be there to attach all necessary equipment, monitor and assist you. Microphones and video cameras will record your breathing and body movements.

Polysomnography (Diagnostic) – At this overnight sleep study, you will be hooked up to equipment that monitors your heart, lung and brain activity, breathing patterns, arm and leg movements, and blood oxygen levels while you sleep. It will be a a full-night study, in which you're monitored all night.

This test will determine if you have obstructive sleep apnea and measure your AHI (apnea-hypopnea index) – this is the number of apneas (periods of no breathing) or hypopneas (abnormally slow or shallow breathing).

In a split-night sleep study, you'll be monitored during the first half of the night with the equipment. And If you're diagnosed with obstructive sleep apnea, the staff may wake you and give you continuous positive airway pressure (cpap) for the second half of the night.

Polysomnography (Titration) – This test can help your doctor adjust positive airway pressure therapy, if appropriate. The technician will calibrate your CPAP therapy pressure, and also fit you for a mask that is best suited for your condition.

Home sleep apnea testing – Depending on your condition the physician may recommend a home sleep test (at home version of a polysomnography) to diagnosis obstructive sleep apnea. There may be a cost for this and is not covered by OHIP.

Shower before your sleep study, and avoid using lotions, oils and makeup on your skin as different wires will be attached to monitor you.
Stick to your sleep routine, do not drink coffee after 5pm to ensure you are able to get a good quality of sleep as the data is required to fully assess your sleep behaviour.
Bring your own pillow, sleepwear, and something to read. Bring a toothbrush, and comb for the early morning.
For the titration study, the sleep technicians may require you to bring your CPAP mask and hosing, if you are on a trial CPAP therapy or have previously had a machine.

Treatments:

Uvulopalatopharyngoplasty (UPPP) is a surgical procedure where the surgeon removes excess tissue from the back of the mouth and top of the throat.

The goal of surgery for sleep apnea is to remove excess tissue from your nose or throat that may be vibrating and causing you to snore, or that may be blocking your upper air passages and causing sleep apnea.
Speak with your doctor about the benefits and risks associated with such a procedure. Many times, the tonsils and adenoids are removed as well.
This surgery is performed at the hospital under gender anesthesia. These procedures don't treat obstructive sleep apnea, but they may reduce snoring.
Many times, patients still require using positive airway pressure therapies even after surgery. This is an elective procedure not usually covered by insurance.

Oral appliances are available with people with mild or moderate obstructive sleep apnea. These devices are designed to keep your throat open.

Another option is wearing a mouthpiece designed to keep your throat open. While positive airway pressure is nearly always an effective treatment, oral appliances are a successful alternative for some patients.
Some are designed to open your throat by bringing your jaw forward, which can sometimes relieve snoring and mild obstructive sleep apnea.
Others hold your tongue in a different position. If you and your doctor decide to explore this option, you’ll need to see a dentist experienced in dental sleep medicine appliances for the fitting and follow-up therapy.
A number of devices are available from your dentist. You may need to try different devices before finding one that works for you.
Because oral appliances aren’t as consistently effective as CPAP, close follow-up is needed to ensure successful treatment of sleep apnea.
Costs for these devices are not covered by most insurance companies.

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