How Do You Get Screened for Sleep Apnea?
Last updated: March 2023
You’ve been told you snore enough to awaken the entire household. Or, you discover yourself waking up over and over, your heart racing, your throat sore, and your body covered in sweat.
Meanwhile, your days are shaped by periods of fatigue, poor mood, or compelling sleepiness. You have had some close calls while behind the wheel of a car, as well.
These, together or separately, may suggest you’re experiencing obstructive sleep apnea (OSA). What should you do if you suspect you have OSA?
Start with your doctor
Primary care doctors may not conduct full-blown OSA tests, but they do generate necessary referrals to the sleep specialists who do.
Your general practitioner will likely screen you first. Doing so saves everyone time and money. Not only can a screening potentially confirm your concerns, but it can also identify whether you qualify for a home sleep apnea test. Also, insurance companies may require screening for OSA as part of the reimbursement process.
The screening itself is simple: a questionnaire. The information your doctor gleans from the questionnaire – along with your medical history and current complaints – generally provides enough criteria for them to proceed with a referral to a sleep specialist.
About sleep questionnaires
These surveys are easy to take – you simply answer a few questions from a checklist. Your answers are scored. Your final score can indicate your need to further investigate a potential case of undiagnosed OSA.
The following questionnaires are most commonly used to screen for OSA:1
- Epworth Sleepiness Scale (ESS)
- STOP-BANG questionnaire (STOP-BANG)
- Berlin questionnaire (Berlin)
Epworth Sleepiness Scale (ESS)
This is the most common questionnaire, with 8 easy-to-answer questions. It measures the risk of falling asleep in familiar real-life situations (such as while you’re in a barber’s chair or at the movies). The ESS is also used to measure the effectiveness of therapy following a sleep disorder diagnosis.1
STOP-BANG questionnaire (STOP-BANG)
This questionnaire has an acronym for its name. The name is made up of:1
- Observed apnea
- Blood Pressure
- Body mass index
- Neck circumference
This survey was first developed to screen people before surgery. It’s also useful in primary care visits for people complaining of sleep problems.1
Berlin questionnaire (Berlin)
Some doctors prefer to use the Berlin. This questionnaire serves the special interests of doctors whose patients work in occupations where safety is critical (machinery operation or driving, for example). It has 10 questions that target 3 areas relevant to OSA:1
- Daytime sleepiness
- A medical history of high blood pressure or obesity
Responses are scored in a different analytical process that’s good at identifying potential OSA.1
Other ways to be screened for sleep apnea
Drowsy driving among long-haul truck drivers is considered a significant public health and safety concern. Untreated sleep disorders (like OSA) are a chief cause of drowsy driving. Among commercial truck drivers, it’s estimated that about a third have OSA. Ensuring all drivers are healthy and treated for existing OSA is critical to the safety of all who use our highways.2
People who drive commercial vehicles are typically required to undergo physical exams under the observation of the Department of Transportation (DOT) to ensure their fitness behind the wheel. These tests include screening measures to identify possible OSA.
If a DOT medical examiner identifies undiagnosed OSA in a driver, that driver will be asked to follow diagnostic and treatment protocols in order to maintain the commercial driver’s license (CDL) credentials necessary to keep their job.3
With so many chronic illnesses having confirmed links to untreated OSA (such as heart disease, stroke, and diabetes), some hospitals are turning to sleep navigators to screen for OSA.
The sleep navigator is a medical professional who visits specific kinds of patients newly admitted to the hospital. Usually, these patient admissions are related to acute cardiovascular problems that require surgery. Sleep navigators briefly interview these patients about their sleep health prior to surgery.
Based on these one-on-one live screenings, they can identify people who should pursue OSA diagnostic testing in conjunction with other treatment and therapy decisions linked to the chronic health conditions that initially landed them in the hospital.4
What happens next?
However you’re screened for OSA, if the screening confirms that you have it, you’ll next visit a sleep specialist. Following your sleep study, the sleep specialist will be better able to guide your therapies so you can enjoy much healthier sleep in the future.
Tell us about your sleep screening experience. Share your sleep apnea story or comment below.
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