Sleep apnea diagnostic criteria

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saarah T. Alkhairy, M.D.; Kiran Singh, M.D. [2]

Overview

The diagnosis of sleep apnea is listed in the DSM-V guidelines using either either the Apnea Hyponea Index (AHI) or the Respiratory Disturbance Index (RDI).

Sleep Apnea Diagnostic Criteria

The common indices used to assess breathing are Apnea Hyponea Index (AHI) and Respiratory Disturbance Index (RDI)

• AHI is the number of apneas or hypopneas recorded during the study per hour of sleep
• RDI is the average number of respiratory disturbances (obstructive apneas, hypopneas, and respiratory event-related arousals [RERAs]) per hour

• None/Minimal OSA: AHI = 0-4
• Mild OSA: AHI = 5-14: Patients may either be asymptomatic or may complain of sleepiness when they are sedentary. The daytime sleepiness often does not impair the patients' quality of life.
• Moderate OSA: AHI = 15-29: Patients are usually symptomatic.
• Severe OSA: AHI ≥ 30: Patients' symptoms are severe enough to interfere with daily activities. They may fall asleep during activities that require attention (e.g. driving)

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DSM-V Diagnostic Criteria for Obstructive Sleep Apnea At least one of the following criteria must be met:: 1. Evidence by polysomnography of AHI or RDI ≥ 5 and ≤ 14 events per hour of sleep PLUS either of the following sleep symptoms: Nocturnal breathing disturbances: any of snoring, snorting/gasping, or breathing pauses during sleep, OR Any of daytime sleepiness, fatigue, or unrefreshing sleep despite sufficient sleep that is not better explained by any other disorder (including other sleep disorders) OR 2. Evidence by polysomnography of either AHI or RDI ≥ 15 events per hour of sleep regardless of presence/absence of clinical manifestations DSM-V Diagnostic Criteria for Central Sleep Apnea Both criteria must be met:: 1. Evidence by polysomnography of AHI or RDI greater than or equal to 5 events per hour of sleep AND 2. The disorder is not better explained by another current sleep disorder

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