Abstract
Diagnostic evaluation for obstructive sleep apnea (OSA) should occur in the context of a comprehensive sleep evaluation.
History and physical examination, questionnaires, and clinical prediction tools are not sufficient to make a diagnosis of OSA. Attended polysomnography is the recommended test and gold standard for the diagnosis of OSA. Home sleep apnea testing with a technically adequate device may be used for the diagnosis of OSA in an uncomplicated adult patient with a high pretest probability for moderate-to-severe OSA. Attended polysomnography should be performed after a negative, inconclusive or technically inadequate home sleep apnea test. Home sleep apnea testing does not typically have electroencephalogram (EEG) and cannot measure sleep time or sleep fragmentation which can occur with some forms of sleep apnea, leading to underestimation of the severity of sleep-disordered breathing in some cases. Home sleep apnea testing does allow for a more cost-effective option and allows the patient to be tested at home in their typical sleep environment.
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Further Reading
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Mansukhani, M.P., Kolla, B.P., Ramar, K. (2021). Diagnostic Testing for Obstructive Sleep Apnea. In: Kim, K.B., Movahed, R., Malhotra, R.K., Stanley, J.J. (eds) Management of Obstructive Sleep Apnea. Springer, Cham. https://doi.org/10.1007/978-3-030-54146-0_7
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