Health Library Should I Have a Sleep Study to Diagnose Obstructive Sleep Apnea?From Healthwise

This information will help you understand your choices, whether you share in the decision-making process or rely on your doctor's recommendation.

Key points in making your decision

The most common form of sleep apnea is obstructive sleep apnea (OSA). Although doctors use sleep studies to diagnose both obstructive sleep apnea and central sleep apnea, this Decision Point focuses on obstructive sleep apnea.

Consider the following when making your decision:

• If you snore but do not have other symptoms of sleep apnea, you may not need a sleep study. Lifestyle changes, such as losing weight (if needed), sleeping on your side, and keeping a regular sleep schedule may reduce your snoring.
• If you have symptoms of sleep apnea (particularly excessive snoring or daytime sleepiness), your doctor will probably suggest a polysomnography sleep study. Polysomnography is the only sure way to find out whether you have sleep apnea.
• If you know that you have sleep apnea, you can treat it.
  • If you have mild sleep apnea, or more severe sleep apnea without daytime sleepiness, treatment may or may not reduce your symptoms and complications such as high blood pressure.
  • If you have moderate to severe sleep apnea, treatment generally reduces symptoms of sleep apnea and may reduce your risk of complications.

What is sleep apnea?

Sleep apnea occurs when you regularly stop breathing for 10 seconds or longer during sleep. It can be mild, moderate, or severe, depending on the number of times an hour that you stop breathing (apnea) or that airflow to your lungs is reduced (hypopnea). Apnea episodes may occur from 5 to 50 times an hour.

What causes obstructive sleep apnea?

A blockage or narrowing of the airways in your nose, mouth, or throat generally causes obstructive sleep apnea (OSA). This usually occurs when the throat muscles and tongue relax during sleep and partially or completely block the airway.

Sleep apnea can also occur if you have bone deformities or enlarged tissues in your nose, mouth, or throat. For example, you may have enlarged tonsils. During the day when you are awake and standing up, this may not cause problems. But when you lie down at night, the tonsils can press down on your airway, narrowing it and causing sleep apnea.

Other factors that make sleep apnea more likely include using certain medicines or alcohol before bed, sleeping on your back, and being obese.

Why should I have a sleep study?

A sleep study can give you a positive diagnosis of sleep apnea. This is important because if sleep apnea is not diagnosed and treated, it can interfere with your quality of life. If you have sleep apnea, you may be at risk for excessive daytime sleepiness and complications such as high blood pressure, high blood pressure in the lungs (pulmonary hypertension), depression, irregular heart rhythms, heart failure, coronary artery disease, and stroke.

Will treating sleep apnea help me?

Research shows that treating sleep apnea can reduce sleepiness.^{1, 2} It may also improve blood pressure.^{3, 4, 5} For people with sleep apnea and coronary artery disease, treatment of sleep apnea can lower the risk of some problems such as heart failure.⁶

If you need more information, see the topic Sleep Apnea.

Your choices are to:

• Have a sleep study.
• Try ways to reduce snoring and not have a complete sleep study.

The decision about whether to have a sleep study takes into account your personal feelings and the medical facts.

These personal stories may help you make your decision.

Use this worksheet to help you make your decision. After completing it, you should have a better idea of how you feel about having a complete sleep study. Discuss the worksheet with your doctor.

Circle the answer that best applies to you.

Use the following space to list any other important concerns you have about this decision.

What is your overall impression?

Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to have or not have a sleep study.

Check the box below that represents your overall impression about your decision.

Return to the topic:

• Sleep Apnea
• Sleep Studies
• Snoring

Citations

1. Giles TL, et al. (2006). Continuous positive airways pressure for obstructive sleep apnoea in adults. Cochrane Database of Systematic Reviews (4). Oxford: Update Software.

2. Hensley M, Ray C (2006). Sleep apnea. Clinical Evidence (15): 1–18.

3. Pepperell JC, et al. (2002). Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: A randomised study. Lancet, 359(9302): 204–210.

4. Becker HF, et al. (2003). Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea. Circulation, 107(1): 68–73.

5. Norman D, et al. (2006). Effects of continuous positive airway pressure versus supplemental oxygen on 24-hour ambulatory blood pressure. Hypertension, 47(5): 840–845.

6. Milleron O, et al. (2004). Benefits of obstructive sleep apnoea treatment in coronary artery disease: A long-term follow-up study. European Heart Journal, 25(9): 728–734.

Author:	Maria G. Essig, MS, ELS	Last Updated: July 13, 2007
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine Jan Ulfberg, MD, PhD - Sleep Disorders
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