Obstructive sleep apnea: Screenings in primary, secondary and tertiary care settings

Abstract

Insomnia is a major health problem affecting millions of people around the globe, particularly in the developed world, substantially impacting on individual work performance and raising disability costs. Insomnias can be broadly divided into primary and secondary types. Primary insomnias can further be divided into parasomnias and dyssomnias. Diagnostic approaches to insomnias can be challenging, thereby complicating the treatment process. Obstructive sleep apnea (OSA) falls under the category of primary insomnias and is a good example of frequently missed diagnoses. The goal of this paper is to document the development of a self-reporting sleep apnea scale based on graded percentage scores to correlate with primary, secondary and tertiary risks. Scores falling under fifty percent represent primary prevention risks of OSA and suggest possible interventions. A score of fifty percent highlights three core symptoms on the scale as described in detail below to represent early detection of OSA or secondary prevention. Finally, scores exceeding fifty percent will include associated risks of comorbidities as well as other factors contributing to OSA, or tertiary prevention, with separate scores assigned to individual risk factors. Analysis of final scores on the proposed scale would therefore, in our opinion help achieve the goal of grading the risk of OSA from a multidisciplinary preventive care aspect.