Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • sleep partner complaints
  • delayed sleep onset
  • multiple or long awakenings

Other diagnostic factors

  • impairment of functioning
  • accidents
  • decreased sleep time
  • daytime napping
  • thyrotoxicosis
  • enlarged tonsils or tongue
  • micrognathia and retrognathia
  • lateral narrowing of oropharynx

Risk factors

  • female gender
  • advanced age
  • chronic medical conditions
  • chronic pain (e.g., hip impairment)
  • psychiatric illness
  • alcohol or substance abuse
  • stimulant usage
  • poor sleep hygiene
  • medications
  • recent travel across time zones
  • night work
  • thyroid dysregulation

Diagnostic investigations

1st investigations to order

  • Pittsburgh Sleep Quality Index (PSQI)
  • Insomnia Severity Index (ISI)
  • Stanford Sleepiness Scale (SSS)
  • Epworth Sleepiness Scale
Full details

Investigations to consider

  • polysomnography (PSG)
  • actigraphy
  • sleep diary
  • TSH
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Teofilo Lee-Chiong

Professor of Medicine

Chief, Division of Sleep Medicine

Department of Medicine

National Jewish Health Denver

Professor of Medicine

School of Medicine

University of Colorado

Denver

CO

Disclosures

TLC is the Chief Medical Liaison for Philips, a company that makes devices to treat sleep apnea.

Vipin Malik

Associate Professor of Medicine

Division of Pulmonary, Critical Care and Sleep Medicine

National Jewish Health Denver

Assistant Professor of Medicine

Pulmonary Sciences and Critical Care Medicine

University of Colorado

Denver

CO

Disclosures

VM received research funding from Philips Respironics for a study on COPD-OSA overlap.

Peer reviewers VIEW ALL

Director

Sleep Disorders Center

Thomas Jefferson University Hospital

Philadelphia

PA

Disclosures

KD is a speaker for Sanofi-Aventis, King Pharmaceuticals, Takeda Pharmaceuticals, Sepracor, and Pfizer; a consultant for Sanofi-Aventis, Takeda Pharmaceuticals, Sepracor, Pfizer, and Neurocrine Biosciences; and has stock in Merck.

Assistant Professor

Geriatric Psychiatry and Neuropsychiatry

The Johns Hopkins Hospital

Baltimore

MD

Disclosures

CUO declares that he has no competing interests.

Medical Director

Kings Harbor Multicare Center

Bronx

NY

Disclosures

RG declares that he has no competing interests.

Affiliate Assistant Professor

Department of Psychiatry and Behavioral Sciences

University of Washington Medical Center

Seattle

WA

Disclosures

CS declares that he has no competing interests.

Director

Melbourne Sleep Disorders Centre

Melbourne

Victoria

Australia

Disclosures

DC has received consulting fees from Sanofi-Aventis and Lundbeck, and honoraria for speaking from Sanofi-Aventis.

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