Evaluating a Case of Sleep Apnoea. Dr J.M. Joshi Professor and Head Department of Pulmonary Medicine T.N. Medical College B.Y.L. Nair Hospital Mumbai. SAS. Sleep apnoea syndromes (SAS) represent a group of conditions with abnormal respiration during sleep
Evaluating a Case of Sleep Apnoea
Dr J.M. Joshi
Professor and Head
Department of Pulmonary Medicine
T.N. Medical College
B.Y.L. Nair Hospital
Snoring is the cardinal symptom,cyclical with periods of loud snoring exceeding 100 decibels or snoring alternating with quieter intervals of apnoeas
B) 2 of the following
c) Sleep Study showing AHI > 5
Ref: PSG Task Force, ASDA. Sleep 1997;20:406-22.
Ref: Clinical guidelines for unattended PM in the diagnosis of OSA in adult patients. J Clin Sleep Med 2007; 3:737–747
Ref: Likelihood ratios for a sleep apnea clinical prediction rule. AJRCCM 1994;150:1279-85.
Magnitude of OSA and paucity of sleep labs needs simplified approaches for physicians
Enough evidence now exists that simple ambulatory diagnostic–therapeutic strategies have equivalent clinical outcome in cases with high pretest probability
Patients who have a low probability, have co-morbidities or have difficulties during ambulatory management should be referred to a sleep centre for detailed evaluation/in-laboratory attended full PSG and further management