If you suspect that you have sleep apnea, the usual first step is to discuss your suspicions with your primary care physician. Your doctor may evaluate your symptoms first and then decide whether you need to see a sleep specialist to diagnose sleep apnea.
Sleep specialists are doctors who diagnose and treat people who have sleep problems. Examples of such doctors include lung specialists (like Pulmonologists) and ear, nose, and throat (ENT) specialists.
Usually, doctors diagnose sleep apnea based on medical and family histories, a physical exam, and sleep study results.
1. Physical Examination
In some cases a doctor may administer a simple check of your mouth, throat, and neck to determine if you have obstructive sleep apnea (OSA). In these physical examinations the doctor is looking for abnormalities or excessive fatty issues of the uvula, tongue, soft palate, or checking for enlarged tonsils and adenoids. With children, doctors often only need a physical examination to determine that tonsils and adenoids are the cause of OSA.
2. Polysomnogram (PSG)
If your doctor believes you may have moderate to severe OSA, he will probably refer you to a sleep specialist for a sleep study. During the sleep study, you will spend the night at a sleep clinic where you will be hooked up to diagnostic machines that measure and record your heart, lung and brain activity, breathing patterns, arm and leg movements, body positions, and blood oxygen levels while you sleep. These tests are painless and non-invasive and generally take six hours to complete.
3. Home Sleep Test (HST)
If you live far from a sleep clinic, uncomfortable sleeping away from home, or can’t afford the full in-lab PSG sleep test, an HST might be best for you. While not as in-depth of a study as a PSG, an HST is a test that you can take home overnight for a similar assessment. An HST monitors airflow, respiratory effort, breathing patterns, blood oxygen levels, and even body positions. The information is either transmitted wirelessly to the sleep clinic, or stored on a memory card for later drop-off.
Costs x Risks
The cost of diagnosing and treating sleep apnea is significant, generally well over $1,000, and if PAP therapy is prescribed, charges will be ongoing. If you are uninsured or underinsured, you may be tempted to delay action. But remember, if left untreated, sleep apnea can cause high blood pressure, heart disease, stroke, diabetes, depression, and other ailments. Diagnosis and, if necessary, treatment may be well worth the price.