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Tips on Detecting Sleep Apnea

Tips on Detecting Sleep Apnea

In his Hypertension Q&A, "When Snoring Has More Ominous Consequences Than a Sleepless Spouse" (CONSULTANT, October 2003, page 1410), Dr Donald Vidt suggests several questions that a physician can ask patients to screen for obstructive sleep apnea (OSA). However, these are leading questions (eg, "Are you tired on awakening?") that are likely to be answered in the affirmative. False-positive answers to such questions provide erroneous information that can lead to unnecessary testing. ---- Thomas Coniglione, MD
Oklahoma City

You are indeed correct; if the screening questions are used alone, the answers might provide erroneous information. However, these questions can detect some of the most prominent symptoms of OSA, such as loud snoring, morning tiredness, and excessive daytime sleepiness. To ensure the reliability of the history, I also include the Epworth Sleepiness Scale, which is a more objective tool that has been subjected to testing and validation. Because OSA is suspected to be highly prevalent among hypertensive patients--particularly those who are obese--it is important to search for evidence of obstructive sleep patterns. ---- Donald G. Vidt, MD
Consultant, Department of Nephrology and Hypertension
The Cleveland Clinic Foundation

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