Diagnosis of obstructive sleep apnea in ambulatory practice

General Medicine, 2025, 27(5), 48-54.

R. Bilyukov

Department of Pulmonology, UMHAT “Alexandrovska”, Medical University ‒ Sofia

Abstract. Obstructive sleep apnea syndrome (OSA) is a common condition associated with significant health consequences and involvement of various organs and systems. The relationship between obstructive sleep apnea and serious cardiovascular diseases, metabolic syndrome, diabetes mellitus, and increased mortality makes the early and accurate diagnosis particularly important. General practitioners represent the primary level where patients seek help and play an important role in the diagnosis of this type of sleep-disordered breathing. The first steps in diagnosing obstructive sleep apnea are often taken in ambulatory practice and consist of identifying patients with a risk profile and recognizing the symptoms of the disease. After detailed history taking and physical examination, standardized scales and questionnaires can be applied to quantitatively assess the main symptoms of the patients. In cases of doubt or contradictory results, instrumental screening methods may be employed – nocturnal pulse oximetry, respiratory polygraphy, and others. Night polysomnography is the only objective method and gold standard in the diagnosis of sleep apnea. The examination is conducted in specialized centers by trained personnel and provides comprehensive information regarding multiple vital signs during sleep and their dynamics. General practitioners have a fundamental role in the diagnostic process and therapeutic follow-up of patients with obstructive sleep apnea. Increased awareness regarding risk factors and clinical presentation of this common sleep disorder would contribute to improving the health status and the patient quality of life. The aim of this review is to present the principal diagnostic methods for obstructive sleep apnea applicable in ambulatory practice.

Key words: sleep apnea, symptoms, comorbidities, ambulatory practice, diagnostic methods

Address for correspondence: R. Bilyukov, MD, e-mail: r.bilyukov@gmail.com