How Do You Get Screened for Sleep Apnea?
You’ve been told you snore enough to awaken the entire household. Or, you discover yourself waking up frequently all night long, your heart racing, your throat sore, 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
General physicians 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 your survey — when matched with your medical history and current complaints — generally provides enough criteria for them to proceed with referrals to a sleep specialist.
About sleep questionnaires
These surveys are easy to take: you simply answer a few questions from a specialized 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:
- 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.
STOP-BANG questionnaire (STOP-BANG)
This questionnaire has an acronym for its name. The first letter of each word in STOP-BANG references:
- Observed apnea
- Blood Pressure
- Body mass index
- Neck circumference
This survey was first developed to screen people during pre-operative assessments. It’s also useful in the primary care visit for people complaining of sleep problems.
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, as examples).
It has 10 questions that target 3 areas relevant to OSA:
- Daytime sleepiness, and
- A medical history of high blood pressure or obesity
Responses are scored in a different analytical process that’s highly sensitive in identifying potential OSA.
Other ways to be screened
The DOT Physical
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.1
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 patient who’s a driver, that patient will be asked to follow diagnostic and treatment protocols in order to maintain commercial driver’s license (CDL) credentials necessary to keep their jobs.2
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 which 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 patients 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.3
What happens next?
However you’re screened for OSA, if the outcome confirms your suspicion (that you have OSA), you’ll next visit a sleep specialist. Following your sleep study, they’ll be better able to guide your therapies so you can enjoy much healthier sleep in the future.
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