The latest now is that if you don’t have symptoms of sleep apnea, you should not be screened for this common condition.
Current evidence goes against sleep apnea screening as part of routine annual physicals.
One reason, certainly, is the logistics. The diagnosis of sleep apnea requires a sleep study, and though this can be done at home, many people—without known symptoms—will not bother with it.
However, screening can also have a pre-screening phase, in which a doctor checks for features that are predictive for obstructive sleep apnea, such as crowded teeth, a tongue with imprints from the teeth, a small airway and a receding chin.
And then, the patient is told they have features suggestive of obstructive sleep apnea, and they then can arrange for a sleep study.
But even this “pre-screening” is not universally performed by physicians, though certainly, there are doctors who will notice these features and begin a talk about obstructive sleep apnea.
More to the Issue of Universal Screening for Obstructive Sleep Apnea
Nevertheless, the U.S. Preventive Service Task Force’s conclusion as of late 2017 is that there just isn’t enough evidence to endorse screening for sleep apnea in adults who do not have symptoms.
“Do not have symptoms” refers to unrecognized symptoms. A person may, indeed, have symptoms of sleep apnea but be unaware, such as snorting and loud snoring, or pauses in breathing during sleep.
Daytime drowsiness often gets overlooked as a sign of sleep apnea and is often chalked up to the byproduct of stress, over-working, passive activities (e.g., waiting a long time for an office appointment) or “bad sleep.”
How many people have asymptomatic sleep apnea?
This is not known.
How many people have symptoms of SA but are not aware of this?
This too is not known.
This lack of data is one of the reasons why the USPSTF does not recommend screening for sleep apnea in those who don’t have symptoms.
• Abrupt wakenings gasping for breath
• Repeatedly waking for no reason
• Waking to urinate at least twice overnight
• Waking with headaches that soon go away
• ADHD-like symptoms during the day
• Easily dozing off while watching TV, doing computer work, reading or being in a car
• High blood pressure that does not respond to drugs, diet or exercise
What about screening with questionnaires?
The USPSTF has determined that giving questionnaires is inadequate.
Screening for sleep apnea in asymptomatic adults is a ways off, nowhere near the status of screening for high blood pressure and diabetes.
According to the USPSTF, there are no studies supporting the concept of sleep apnea screening for the general population.