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Identifying the signs of Obstructive Sleep Apnea (OSA)

Signs and Symptoms
  • Excessive daytime sleepiness (EDS) unexplained by other factors along with loud disruptive snoring or nocturnal choking/gasping/snorting or nocturnal pauses in breathing

Additional Signs/Symptoms of OSA
  • Recurrent nocturnal awakenings Un-refreshing sleep

  • Daytime fatigue

  • Impaired concentration/memory loss

  • Mood/behavioral changes

  • Morning headaches

  • Loss of sexual interest

Standard questions practitioners will ask all patients
  • Do you snore?

  • Have you been told quit breathing or pause your breathing during sleep?

  • Do you awake from sleep choking, snorting or gasping for breath?

*Take into consideration HTN, BMI

  • If needed, ask about other physical characteristics, signs and symptoms

Methods of Screening for OSA
(1) The Berlin Questionnaire
  • The Berlin Questionnaire uses 10 questions to assess: (1) Presence & frequency of snoring behavior, (2) Wake-time sleepiness or fatigue, and (3) History of HTN &/or obesity. The persistence or frequent symptoms in 2 of 3 categories indicates a high likelihood of OSA

  • Simple, self-administered patient questionnaire

  • Asks patients to report their symptoms

  • Questionnaire is specific to OSA

  • Identifies patient at high risk for OSA who is likely to benefit from diagnosis

(2) Epworth Sleepiness Scale
  • 8 questions answered on a scale of 0-3 ( 0= would never doze, 3= high chance of dozing)

  • Score > 10 represents daytime sleepiness


Epworth Sleepiness Scale does not identify cause of sleepiness, but it may include sleep apnea, and also insomnia, lack of time to sleep, etc. Patients with sleep apnea may have normal value scored.

Berlin Questionairr
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