History and physical examination
• A good history from the patient or relatives like spouse or parents.
• Next a physical examination is performed to examine the areas of possible airway collapse. In the nose, this includes the septum, turbinates; nasal polyps, adenoid hypertrophy, and nasopharynx .In the mouth, the palate, tonsils, uvula, pharyngeal walls, and neck circumference are all examined.
A flexible laryngoscopy is usually performed to examine the airway during active breathing and simulated snoring maneuvers. (The laryngoscope is a fiber-optic, flexible tube approximately 18 inches in length and an eighth of an inch in diameter with a camera on its end. The camera end is inserted through the nasal passage to the upper throat or pharynx where the actions of the tongue and palate can be observed.)
Sleep Study: Polysomnography
The primary objective test for obstructive sleep apnea is polysomnography, also referred to as a sleep study. This test measures different physical and physiological parameters while a subject is asleep. During attended polysomnography, a technician observes a person sleeping and monitors recording equipment in the setting of a sleep laboratory. A typical polysomnography test includes: an electroencephalogram (EEG) monitors brain waves, an electro-oculogram (EOG) monitors eye movements, an electromyogram (EMG) monitors muscle activity, measurement of oral and nasal airflow, measurement of chest and abdominal movement, audio recording of the loudness of snoring, blood oxygen levels (oximetry), and video monitoring of the subject during the study.
After polysomnography is completed the data are analyzed by a board certified sleep specialist. The numbers of apneas, hypopneas, leg movements, and desaturations as well as sleep levels are all recorded in a formal report, and a diagnosis is made.
Home Sleep Study:
This is getting more popular these days. Home sleep study is lot more convienientt to the patient and cost effective.
Dynamic MRI is used to locate the site of obstruction by putting the patient into sleep.
Cardiological and Neurological Evaluation
If patient has any cardiac or neurological problems, get the cardiology/neurology doctor to see the patient
If patient is prepared for surgery under general anesthesia, the anesthetist will evaluate the patient.