How To Screen
How To Screen Overview
In order to fully understand the situation of your patient, you must screen your patient. Below are a few ways of screening him/her before your patient takes a sleep test.
1. What to ask about
- Medical History: Letter of referral , previous sleep study reports, comprehensive written history, apnea related and comorbid problems, rule out acute problems.
- Sleep Related History: Snoring (frequency, loudness, effect on sleep of others), Daytime Drowsiness, Quality of Sleep, Usual Sleep Position (snoring in all positions or only on back),
- Epworth Sleepiness Scale
- Patient Examination: Neck Size, Obesity, TMJ, Muscle Palpation, Jaw Range of Motion, Study Casts, Radiographs, Oropharyngeal Tissues
2. What to look for and where
- Thumb/Digit Sucking VS. Thumb/Digit Propping
- Proppers are mouth breathers
- Suckers are nose breathers
- Bruxism (tonic clenching creates abfractions, rhythmic griding creates flat, worn down teeth.
- Dysphagia (scalloped lateral border of the tongue) and Macroglossia (enlarged tongue, enlarged tonsils, enlarged soft palate and uvula, battered uvula
3. What it all means
- Clinical features alone cannot identify obstructive sleep apnea. Prediction models are not accurate enough. Polysomnography is the standard of care.