Diagnosis obstructive sleep apnea

Sleep testing device	Index	Diagnostic criteria for OSA
Polysomnography^*	AHI	AHI 5 to 14/hour sleep plus one or more sleep-associated conditions^¶ or AHI ≥15/hour sleep
Polysomnography^*	RDI	RDI 5 to 14/hour sleep plus one or more sleep associated conditions^¶ or RDI ≥15/hour sleep
Home sleep apnea device^Δ	REI	REI ≥15/hour total recording time

For the diagnosis of OSA, respiratory events should be identified as primarily obstructive (ie, apneas, hypopneas, arousals that are associated with respiratory effort). These events are used to generate the following indices:

AHI = (apneas + hypopneas / total sleep time in hours)
RDI = (apneas + hypopneas + RERAs / total sleep time in hours)
REI = (apneas + hypopneas / total recording time)

AHI: apnea-hypopnea index; EEG: electroencephalography; RDI: respiratory disturbance index; REI: respiratory event index; RERA: respiratory effort-related arousals; OSA: obstructive sleep apnea.

* Most polysomnography studies will report AHI, RDI, or both values. The clinician should recognize that the RDI may overestimate or the AHI underestimate the number of respiratory events during sleep. However, no consensus has been reached regarding which value is more accurate.

¶ Sleep-associated conditions include the following:

Sleepiness, fatigue, insomnia, or other symptoms leading to impaired sleep-related quality of life
Waking up with breath holding, gasping, or choking
Habitual snoring or breathing interruptions during sleep noted by a bed partner or other observer

Δ Home devices vary significantly in what data they collect. For example, type 3 and 4 devices do not typically detect arousals from sleep because they do not include EEG data. The clinician should be aware of the limitations of the device used.

Graphic 121160 Version 3.0

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Diagnosis obstructive sleep apnea