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Diagnosis of sleep apnea
Clinical signs and symptoms such as snoring, excessive daytime sleepiness and witnessed apneas could be related to sleep apnea. However, none of them are specific to the syndrome. For that reason, the gold standard of diagnosis is a test called Polysomnography. It is a multi-parametric sleep study performed at a sleep laboratory. It monitors brain function, heart rhythm, muscle activity and the breathing functions. The examinations record the occurrence of apneas and hypopneas. Obstructive sleep apnea is diagnosed at a minimum of 5 episodes per hour of sleep. The severity of sleep apnea is then determined with the apnea-hypopnea index.
Usually, the diagnosis is performed by a pulmonologist after performing the necessary tests. The reference can, however, be obtained by your family doctor. Sleep apnea is one of those diseases that require a multidisciplinary approach in order to diagnose and treat. Your dentist can be helpful in the diagnosis as he/she is a medical professional who sees their patients more often than other medical specialties. The dentist should examine the patients for risks of sleep disorders by examining characteristics such as breathing, snoring, sleepiness and morning headaches in the presence of risk factors specified earlier in the article.
How is sleep apnea treated?
There are multiple approaches to treatment of obstructive sleep apnea. All of them however require tight collaboration between the physicians who are part of the diagnostic process.
With light sleep apnea, treatment would be more conservative. It often involves lifestyle changes such as alcohol moderation, weight loss1 and smoking cessation.
In instances of moderate to severe apnea, the treatment of choice is usually the continuous positive air pressure therapy (CPAP therapy). A CPAP machine provides positive air-pressure in order to counteract the negative transmural pressure that promotes collapse of the upper airway. It remains the first-choice of treatment for most cases of symptomatic sleep apnea.
Treatment for mild sleep apnea
There exists another form of treatment for mild to moderate obstructive sleep apneas. It comes in the form of mandibular repositioning appliances (MRAs). These appliances function by moving the lower jaw forward which moves the tongue forward and increases the dimensions of the upper airways. However, their effectiveness should always be confirmed with a sleep study.
How to get diagnosed with sleep apnea?
In order to be admitted to a sleep laboratory, a person must present a prescription which is usually made by his/her family doctor, ORL or pulmonologist.
Afterwards, one can communicate with a sleep laboratory to schedule a test. Most sleep laboratories are situated in hospitals and their services are covered by the Regie d’assurance maladie du Quebec. However, the wait time can be fairly long. You can also pass a test at a private clinic but these tests will not be covered by the RAMQ .
Here is a list of private laboratories:
Centre du Sommeil de Montréal – Montreal Sleep Center
16.5 km · 4427 Rue Sherbrooke O
Sleep Apnea Solutions
16.2 km · 4141 Rue Sherbrooke O
Clinique Sommeil Sante
22.4 km · 8570 Boulevard Newman
To see a video about sleep apnea
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