Tips on Detecting Sleep Apnea

In his Hypertension Q&A, "When Snoring Has More OminousConsequences Than a Sleepless Spouse" (CONSULTANT,October 2003, page 1410), Dr Donald Vidt suggestsseveral questions that a physician can ask patients to screenfor obstructive sleep apnea (OSA). However, these are leadingquestions (eg, "Are you tired on awakening?") that arelikely to be answered in the affirmative. False-positive answersto such questions provide erroneous information thatcan lead to unnecessary testing.---- Thomas Coniglione, MD
Oklahoma City
You are indeed correct; if the screening questionsare used alone, the answers might provide erroneousinformation. However, these questionscan detect some of the most prominent symptomsof OSA, such as loud snoring, morningtiredness, and excessive daytime sleepiness. To ensure thereliability of the history, I also include the Epworth SleepinessScale, which is a more objective tool that has beensubjected to testing and validation.Because OSA is suspected to be highly prevalentamong hypertensive patients--particularly those who areobese--it is important to search for evidence of obstructivesleep patterns.---- Donald G. Vidt, MD
Consultant, Department of Nephrology and Hypertension
The Cleveland Clinic Foundation