Obstructive Sleep Apnea

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followed up accordingly.

**Chapter 8**

**Abstract**

**1. Introduction**

Diagnosis

*Murat Kayabekir*

Obstructive sleep apnea (OSA) is often confused with the clinical symptoms of other adult/pediatric medical conditions and neurological disorders. Since OSA affects all systems in the body, it is important to establish a correct diagnosis. The first step in the evaluation of a patient with a sleep disorder is to identify the primary symptom. A detailed history of the sleep and wakefulness cycles constitutes the second step. This is followed by the medical history of the patient; a list of previously used medications; family history; detailed information about school, work, family, and social life; and a physical exam of bodily systems. Relevant laboratory tests are performed for differential diagnosis. Polysomnography (PSG) is a golden standard diagnostic method that records electrophysiological signals used for sleep physiology and diseases. PSG is an indispensable method in the diagnosis of OSA.

**Keywords:** anamnesis, symptoms, physical examination, electrophysiology, PSG,

Although OSA is described as an upper airway disorder occurring during sleep; it should be regarded as a clinical syndrome by taking into consideration its adverse effects on bodily systems. In the presence of symptoms like snoring, sleepiness during daytime, not being able to lose weight, weight increase, apnea observed by close family members, arousal with a feeling of suffocation during the night, profuse sweating of the chest and the neck, nocturnal arrhythmias, nocturia, enuresis, sexual impotence, depression, anxiety, forgetfulness, attention deficit, difficulty in concentration, learning problems, personality changes, deterioration of decision-making ability, morning headaches, dry mouth in the morning, bruxism, gastric reflux symptoms, sleeplessness, abnormal motor activity during sleep, and somnambulance, we should keep OSA in mind. However, all these symptoms guide patients to apply to different medical disciplines, causing confusions of diagnosis and eventually leading to delays in correct diagnoses. When patients have OSA, they can go to "neurology, ear nose throat, dentistry, psychiatry, pulmonology, cardiology, pediatric neurology, pediatric cardiology, internal medicine, neurosurgery, and endocrinology" departments. Therefore, we can say that OSA is a multidisciplinary disease. When we consider the increased workload burden in these disciplines, we appreciate that there can be further delays in establishing an OSA diagnosis in the process. So, in hospitals the diagnosis of sleep physiology and diseases should be made by "clinical physiology, electrophysiology, neurophysiology, and sleep laboratories". Through these laboratories, all medical disciplines should be informed with reports for the correct diagnosis and treatment of these patients, and they should be

sleep breathing disorders, snoring and OSA
