Diagnosing and Treating Obstructive Sleep Apnea (OSA)
What to Expect
If you suspect that you might have obstructive sleep apnea (OSA), your healthcare provider will ask you questions about your sleep and health habits. He or she will also physically examine you to look for risk factors, including anything that might make your upper airway smaller. Because OSA runs in families, they may ask questions about your family history of sleep problems. The doctor will carefully review all of the medication you take to see how they might affect your sleep. You'll also be asked questions about your symptoms, as well as your sleep habits. Asking about how much sleep you get, how long it takes to fall asleep and whether you sleep walk or talk will help the doctor spot any other sleep problems you might have. If your healthcare provider thinks that you may have OSA, they may send you for a diagnostic test.
How OSA Is Diagnosed
Your OSA can be diagnosed either by visiting a laboratory for a sleep test (polysomnogram [PSG]) or by using a portable sleep apnea test at home (Out of Center Sleep Testing [OCST]). The most commonly done test is the PSG, which requires you to stay overnight at a sleep laboratory. During this test, you are hooked up to equipment that monitors your heart, lung, and brain activity, breathing patterns, arm and leg movements, and oxygen levels while you sleep. If you stop breathing during sleep, you may be diagnosed with OSA. This test can determine how serious your OSA is based on how many times you stop breathing per hour of sleep.
OCST often can be done at home. Someone will teach you how to put on the device before you sleep. These tests typically collect less information than a laboratory sleep test and only monitor if you stop breathing. The at-home test also might miss mild cases of OSA. If you have many risk factors and symptoms of OSA and the at-home test doesn't pick up your OSA, your doctor may still want you to be tested in a sleep laboratory.
How OSA Is Treated
There are several ways to treat OSA. No matter what treatment you choose, your doctor may want you to do a follow-up sleep study to make sure your OSA is under control.
Continuous Positive Airway Pressure (CPAP): CPAP is a machine that gently blows air into your airway to keep it open while you sleep. You wear a mask that either fits into your nostrils, over your nose and/or over your mouth. Because CPAP works so well, it's often the first treatment your health-care provider will have you try. It should be used every night for the best treatment.
Oral Appliances (OAs): OAs can treat mild to moderate OSA and also can be used if you can't wear a CPAP. OAs are dental devices that open your throat by bringing your jaw forward while you sleep.
Surgery: If you can't tolerate other treatment options, you might consider surgery. OSA surgery reduces the tissue in the back of your throat, pulls your tongue forward, and inserts a nerve stimulator to open your airway so you can breathe easier while sleeping.
Lifestyle Changes: Your doctor often will recommend that you make some lifestyle changes along with other treatments.
- Weight loss: Losing just 10% of your body weight can improve your sleep apnea. Sometimes losing weight may even cure OSA.
- Avoid alcohol and some medications: Your doctor may recommend that you stop drinking alcohol, or taking certain pain or sleeping medications. These substances can make OSA worse.
- Quit smoking: This may improve your OSA because cigarette smoke can increase swelling in your airway.
- Don't sleep on your back: Sleeping on your back may make your OSA worse.
This content was developed in partnership with the CHEST Foundation, the philanthropic arm of the American College of Chest Physicians.