How Is Sleep Apnea Diagnosed?

Your doctor will do a physical exam and take a medical history that includes asking you and your family questions about how you sleep and how you function during the day. As part of the exam, your doctor will check your mouth, nose, and throat for extra or large tissues; for example, tonsils, uvula (the tissue that hangs from the middle of the back of the mouth), and soft palate (the roof of your mouth in the back of your throat).

Your doctor may order a sleep recording of what happens with your breathing while you sleep. A sleep recording is a test that is often done in a sleep center or sleep laboratory, which may be part of a hospital. You may stay overnight in the sleep center, although sleep studies are sometimes done in the home. The most common sleep recording used to find out if you have sleep apnea is called a polysomnogram (poly-SOM-no-gram), or PSG. This test records:

• Brain activity
• Eye movement
• Muscle activity
• Breathing and heart rate
• How much air moves in and out of your lungs while you are sleeping
• The percentage of oxygen in your blood

PSG is painless. You will go to sleep as usual. The staff at the sleep center will monitor your sleep throughout the night. The results of your PSG will be analyzed by a sleep medicine specialist to see if you have sleep apnea, how severe it is, and what treatment may be recommended.

In certain circumstances, the PSG can be done at home. A home monitor can be used to record your heart rate, how air moves in and out of your lungs, the amount of oxygen in your blood, and your breathing effort. For this test, a technician will come to your home and help you apply the monitor that you will wear overnight. You will go to sleep as usual, and the technician will come back the next morning to get the monitor and send the results to your doctor.

Once all your tests are completed, the sleep medicine specialist will review the results and work with you and your family to develop a treatment plan. In some cases, you may also need to see another physician for evaluation of:

• Lung problems (treated by a pulmonologist)
• Problems with the brain or nerves (treated by a neurologist)
• Heart or blood pressure problems (treated by a cardiologist)
• Ear, nose, or throat problems (treated by an ENT specialist)
• Mental health, such as anxiety or depression (treated by a psychologist or psychiatrist)