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Sleep Apnea or Sleep Disordered Breathing

By David Thorson, MD



Sleep Apnea is a sleep disorder characterized by breathing patterns during sleep that decreases oxygen due to shallow breathing, pauses in breathing, or infrequent breathing. In the US, it is estimated that there are 22 million patients with moderate to severe symptoms and only 20 % have been diagnosed. Undiagnosed sleep apnea has significant health implications. All of the following diseases are impacted by untreated sleep apnea: coronary artery disease, stroke, elevated blood pressure, a trial fibrillation, work related accidents, motor vehicle accidents, liver disease and diabetes.


While sleep apnea can affect anyone, common risk factors include:

• Male

• Over 40

• Large neck size (17 inches)

• Loud snoring

• Enlarged tonsils

• Small jaw

• Enlarged tongue

• Reflux disease

• Chronic sinusitis

• Allergies

• Family history of sleep apnea

• Deviated septum causing nasal obstruction

• Sleeping meds, anti-anxiety Medication and alcohol affect breathing

• Smokers


There are many ways to be screened for sleep apnea. A bed partner who witnesses breathing pauses is a strong indication. There are a number of screening questionnaires available such as The STOPBANG and Epworth sleepiness scale. See below.


Please take a moment to take the quiz and if you are positive, please contact your physician or provider. A screening test that is positive means you need further testing. Testing for sleep apnea includes home studies and overnight testing in a sleep lab. For patients with a positive screening test and no other significant medical conditions (unstable cardiac disease, history of stroke, out of control diabetes or hypertension to name a few), home sleep studies are a good diagnostic tool. This allows you to sleep in your own bed and simply wear a chest strap and a tube to measure breathing, movement, and oxygen saturation. The cost for home testing is 1/4 to 1/3 of the cost of an overnight sleep study. Overnight sleep lab studies are still the

best test for many patients so please talk to your provider about which test is best for you.


Entira is now doing home sleep studies for appropriate patients. Dr. Jagdeep Bijwadia, board certified sleep and pulmonary disorders will read our sleep studies and consult with Entira patients at our Maplewood/Battle Creek and

Vadnais Heights Clinics.


If your results are positive, you may start treatment with a CPAP or an

oral appliance based on you and your provider’s personal decision. A CPAP

Specialist from Lakeland Health Services will be available all day at Vadnais

Heights on Tuesdays, Inver Grove Heights on Wednesdays and North St.

Paul on Fridays to help patients with any and all of their CPAP needs. For

any questions related to CPAP therapy please call 763-354-7657. Most insurance

companies pay for home sleep studies for appropriate patients and cover

treatment with CPAP or oral appliance.


StopBang Questionnaire



Circle Yes or No

Do you SNORE loudly (louder than talking or loud enough to be heard through closed doors?



Do you often feel TIRED, fatigued, or sleepy during daytime?



Has anyone OBSERVED you stop breathing during your sleep?



Do you have or are you being treated for high blood PRESSURE?









BMI more than 35kg/m2?


BMI Information: Height: ____________ Weight: _____________

(Please enter height and weight, your doctor will calculate your BMI.)



Age over 50 years old?



Neck circumference greater than 16 inches (40cm)?



Gender: Male?







 If you answered YES to 3 or more, speak to your provider.



Epworth Sleepiness Scale

How likely are you to doze off or fall asleep, not just feel tired, in the following situations?  Even if you have not recently been in each situation listed, try to determine how they would have affected you. For each situation, decide whether or not you would have:

No chance of dozing


Mild chance of dozing


Moderate chance of dozing


High chance of dozing




Chance of dozing

Sitting and reading


Watching TV


Sitting inactive in a public place (eg. theater or meeting)


As a passenger in a car for an hour without a break


Lying down in the afternoon if circumstances permit


Sitting and talking to someone


Sitting quietly after lunch without alcohol


In a car while stopped for a few minutes in traffic


Total Score



If your score is great than 10, speak to your provider.



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