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Diagnosis and Treatment of Obstructive Sleep Apnea in Adults

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Background: Diagnosis of Obstructive Sleep Apnea (3 of 3)

The severity of obstructive sleep apnea (OSA) is typically quantified by the number of apneas and hypopneas per hour of sleep measured during overnight monitoring. This measurement is called the apnea-hypopnea index (AHI). AHI, when combined with determinants of obstruction, is the primary measurement for the diagnosis of OSA. To define OSA, the American Academy of Sleep Medicine uses a threshold of 15 events per hour (with our without OSA symptoms) or 5 events per hour with OSA symptoms (unintentional sleep episodes during wakefulness; daytime sleepiness; unrefreshing sleep; fatigue; insomnia; waking up breath-holding, gasping, or choking; or the bed partner describing loud snoring, breathing interruptions, or both during patient’s sleep). The minimum thresholds to diagnose sleep apnea reported in research studies vary from 5 to 20 events per hour, measured by polysomnography. Individuals with frequent events (an AHI greater ≥ 30 events per hour) are more likely to be at risk for adverse outcomes. There is no established threshold level for AHI that indicates the need for treatment.