Diagnostics / ICSD-3: G47.33
Obstructive
Sleep Apnea.
Diagnostic criteria requiring objective polysomnographic evidence of repetitive upper airway collapse during sleep, resulting in oxygen desaturation and cortical arousals.
A. Clinical Criteria (ICSD-3)
Diagnosis requires either A or B, AND C:
- A. The presence of one or more of the following:
- Patient complains of sleepiness, nonrestorative sleep, fatigue, or insomnia symptoms.
- Patient wakes with breath holding, gasping, or choking.
- Bed partner reports habitual snoring, breathing interruptions, or both.
- Patient has been diagnosed with hypertension, mood disorder, cognitive dysfunction, coronary artery disease, stroke, congestive heart failure, atrial fibrillation, or type 2 diabetes mellitus.
- B. Polysomnography (PSG) or Home Sleep Apnea Test (HSAT) demonstrates:
- An Apnea-Hypopnea Index (AHI) or Respiratory Event Index (REI) ≥ 5 events/hr.
- C. OR, PSG/HSAT demonstrates an AHI or REI ≥ 15 events/hr, regardless of accompanying symptoms.
Severity Classification
| Mild | AHI 5 to < 15 |
| Moderate | AHI 15 to 30 |
| Severe | AHI > 30 |
Next Steps
For patients meeting diagnostic criteria, proceed to PAP Therapy Titration Guidelines or evaluate for Oral Appliance Therapy depending on severity and anatomical factors.