The clinical evaluation for a patient being evaluated for presumed OSA represents an essential first step in the diagnosis of this common sleep disorder. The primary care physician or sleep specialist needs to inquire about the key symptoms of sleep apnea, such as EDS, snoring, and witnessed sleep-disordered breathing symptoms; other important symptoms or practices that affect the patient's sleep such as insomnia, sleep hygiene, and the patient's Sleep-Wake schedule also need to be assessed. Symptoms of other sleep disorders, such as those associated with narcolepsy, restless legs syndrome, PLMD, and parasomnias should be ruled out as possible contributors to the patient's sleep complaints. The experienced clinician should be aware of the high prevalence of sleep apnea; the relationships between this disorder and age, gender, and ethnicity; and the more complex associations including those between OSA and cardiovascular disease, glucose intolerance and insulin resistance, depression, pulmonary disease, and hypothyroidism. A careful evaluation of the patient's social, family, medication, and allergy history is critical for identifying or discounting possible risk factors for sleep apnea. The physical examination for adult patients with suspected OSA should be comprehensive, and should include assessment of blood pressure, indicators of obesity (e.g., BMI, neck circumference), nasal function, pharyngeal, and craniofacial features. Lastly, the examinations of pediatric versus adult patients with suspected OSA are not identical, since the presentation, symptoms, and physical signs associated with childhood OSA are markedly distinct from those associated with adult OSA.
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Salvation For The Sleep Deprived The Ultimate Guide To Sleeping, Napping, Resting And Restoring Your Energy. Of the many things that we do just instinctively and do not give much of a thought to, sleep is probably the most prominent one. Most of us sleep only because we have to. We sleep because we cannot stay awake all 24 hours in the day.