Diagnosis of Sleep Apnea

Your Options For Diagnosing Your Sleep Apnea

Studies show that people looking to improve their fitness and health achieve significantly greater results when looking at non-traditional and more modern approaches. Sleep apnea diagnosis and treatment is considered a newer and more modern approach to improving people’s health and well-being. Even in today’s medical practice, it is often overlooked and alarmingly underdiagnosed as a serious medical problem. Effective screening and diagnosis is critical. Recent statistics indicate that sleep apnea may affect nearly 40% of the population.


Step 1:

The first step required in evaluating a person for sleep problems is completed with a detailed patient Health and Sleep Evaluation Questionnaire, which also includes an Epworth Sleep Scale. This basic paperwork/documentation is reviewed and analyzed as a preliminary step towards determining whether further testing is required. Along with the review of health questionnaire, a clinical exam is performed and includes:

  • Weight
  • Neck size
  • Blood pressure, pulse, and temperature
  • Oral exam

During the examination we look for particular symptoms and signs that are common among sleep apnea patients. We take note of such issues as:

  • Scalloped tongues
  • Recession of the gums
  • Large tongues
  • Retruded or small jaws or narrow jaw arches
  • Short necks
  • Postural deficits

Sleep Apnea Signs

If the patient shows higher than average signs of sleep apnea 'characteristics,' then we recommend:

Step 2: Diagnosis

One of the most efficient and quickest ways to test a person’s airway function is to perform an Eccovision rhinometry and pharyngometry testing. We are one of only a handful of offices that can offer such testing in the comfort of our office. This technology provides us with a technologically superior method of evaluating the 'efficiency' of a person’s airway.

The pharyngometry part of the testing helps us to identify the location and severity of any pharyngeal obstruction. It also helps us to determine whether the airway is capable of maintaining good muscle tone and not collapse while exhaling. Patients with sleep apnea problems have highly 'collapsable' tracheas due to weakness of the muscles. The pharyngometry gives us a very accurate indication of how the muscles behave and how the airway functions.

The above two steps are further used in evaluating and qualifying the patient for eventual efficiency of dental sleep appliances. If the combined tests do NOT show that the patient will benefit from appliance wear, than further treatment and needless cost is prevented. Without the use of this technology it is NOT possible to see how a dental appliance can benefit the patient.

The tests are also used to determine how the appliances will be fabricated and then again used to help adjust the orthotics for optimal fit.

If the Eccovision testing shows a high tendency for sleep apnea, then a full PSG (Polysomnography) can be ordered. This testing is usually done at a sleep clinic where you have to spend one full night to complete the study. Alternatively, with recent advancements, the testing can also be done in the comfort of your home with a home sleep study kit which is normally covered by your medical insurance. If you would like to complete a home study we can set one up for you after your examination appointment. You will not have to leave the comfort of your home.

Testing For Sleep Apnea

The final results of any testing is reviewed with a Medical Doctor in charge of the study and a determination is made regarding the best possible form of treatment to be used.

Diagnosis is made using the AHI (Apnea/HypopneaIndex: how many times PER HOUR a person had a respiratory event.)


  • Apnea is an episode of complete stoppage of breathing for at least 10 seconds.
  • Hypoapnea involves an episode of overly shallow breathing or an abnormally low respiratory rate accompanied by a drop in oxygen saturation. This differs from apnea in that there remains some flow of air. Hypopnea is a decrease in breathing that is not as severe as an apnea. Hypopneas usually occur during sleep and can be defined as 69% to 26% of a normal breath. Like apneas, hypopneas also may be defined as a 4% or greater drop in oxygen in the blood. Like apneas, hypopneas usually disrupt the level of sleep. A hypopnea index (HI) can be calculated by dividing the number of hypopneas by the number of hours of sleep.
  • AHI 5-15 AHI 15-30 AHI > 30

Mild Moderate Severe

For patients with AHI up to 30, dental appliances are usually the first choice of treatment. For AHI higher than 30, CPAP machines are the best option of treatment. CPAP machines must be fitted at a licensed sleep facility and the patient must be monitored carefully.

For more information on dental appliances used in treatment, click on this link: Sleep Apnea Treatments

For more information on CPAP problems and intolerance, click here.

Additional Evaluation and Consulting:

Many patients who suffer with sleep apnea may be obese. We will evaluate and help outline a healthy eating program to improve eating habits, and promote overall health. Often, when CPAP or dental appliance therapy is initiated the patient finds it easier to 'diet' and improve overall habits due to the increase in energy and overall health improvement that the treatment promotes. We will also develop a plan to address any specific health issues or concerns that you have. We can also discuss how to use nutrition and sleep treatment to prevent many common ailments. We will evaluate any family history and environmental concerns as well.

We will work closely with your physician to help you address health concerns such as heart disease, diabetes, digestive disorders, skin problems, eyesight, vitality, obesity, and many other issues.

Ongoing Support

We never leave you to fend for yourself after completing your care. Once you are a patient, you will always be considered a patient. We are always available by email, phone, or an in-person consultation. You can always count on us to be right by your side.

You can live 3 weeks without food
You can live 3 days without water
You can only live 3 minutes without oxygen
Diagnosis for sleep apnea and snoring

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