1. Full Polysomnography
This is the most detailed assessment for patient suspected to have sleep apnea. It is a very comprehensive test. After the patient is connected with all the sensors, the patient will sleep as usual and when he wakes up in the next morning, all the dad will be collected and then analyzed. The test can be done at home or in hospitals.
The assessment of sleep apnea by sleep study will tell us whether the patient has central or obstructive sleep apnea, the severity of the conditions, its relation with various sleep stages and associated desaturation, changes in heart rate, snoring and leg movement.
Sleep Apnea Test
This is a newer form of home sleep test that is less complicated and yet able to provide accurate assessment of the severity of obstructive sleep apnea. However, there is much less information about the whole process of sleep so is more suitable for reassessment of patient confirmed to have OSA or for preliminary testing
3. Sleep Strip
This is a very simple and easy to use test and is very comfortable to patient in use, but the result could be an underestimation of the actual severity of the sleep apnea.
4. Oxygen Saturation Monitor
This is a monitor for oxygen saturation commonly employed overnight to estimate the level of oxygenation and documents the episodes of desaturation. This is a very light, handy, easy to use and comfortable device. This test does not directly or indirectly measure the numbers of apnea so this could only give a rough estimate of the severity of the sleep apnea.
5. Flexible Laryngoscopy + Muller Maneuver
This is a very well tolerated procedure; no hospitalization required and usually only a small amount of local anesthetics will needed to be applied to the nose and throat regions.
Muller maneuver is a special technique that by consciously generating a negative pressure state within the upper airway, we would be able to estimate and possibly identify the possible locations and pattern of obstruction.
6. Sleep Endoscopy
This is a procedure to be performed in hospital, where the patient will be induced into a sleep state by medications. Endoscopic assessment will then be performed and the sites of obstruction and patterns of obstruction will then be accurately diagnosed. Since this is a procedures performed in the operative theatre of hospital, it is then more time consuming for the patient and comes with a higher cost.
7. PAP Machine
There are two types of PAP machines: the CPAP and the BiPAP machines. These machines pumps air through tubing and a nasal mask or face mask to keep our airway open. Other accessories including chin strap and humidifier will give further help in special situations.
8. Advantages and Disadvantages of PAP Machine
The PAP machine usually can abolish nearly all of the apnea and hypopnea episodes, and thus offer more complete treatment. Avoiding surgical management will also avoids all the post-operative complications like pain and bleeding.
10. Which Procedures to Choose
For most of the patients who suffer from obstructive sleep apnea, they have obstructions at multiple level and multiple sites, hence frequently require more than one procedures or even more than one stage of surgery to achieve satisfactory result.
9. When to Consider Surgical Management
The advantages of surgical management is that it offered a almost one-off treatment options that could potentially have long lasting effects in treating obstructive sleep apnea.