SLEEP APNEA RESOURCES
Sleep Apnea Diagnosis & Testing
Why Proper Diagnosis Matters
Sleep apnea affects an estimated 30 million Americans, yet the vast majority of cases remain undiagnosed. Without a formal sleep study, it is impossible to know whether your snoring, daytime fatigue, or restless nights are caused by obstructive sleep apnea, central sleep apnea, or another sleep disorder entirely. An accurate diagnosis determines the type and severity of your condition, which directly shapes the treatment approach that will be most effective for you.
A proper diagnosis also establishes a baseline that your healthcare providers use to measure treatment success over time. If you have been experiencing signs and symptoms of sleep apnea, getting tested is the essential next step. At Glendale Dental Wellness, Dr. Ivan Chan guides patients through the diagnostic process and collaborates closely with sleep physicians to ensure you receive the right diagnosis and the right care.
Types of Sleep Studies
There are two primary types of sleep studies used to diagnose sleep apnea:
- Home Sleep Test (HST) — a simplified, portable diagnostic tool you use in your own bed. It records airflow, blood oxygen saturation, chest movement, and heart rate. More convenient and less expensive than in-lab studies, covered by most insurance plans.
- In-Lab Polysomnography (PSG) — the gold standard for sleep apnea diagnosis. This comprehensive overnight study takes place in a sleep center with multiple sensors recording brain waves, eye movements, muscle activity, airflow, oxygen levels, heart rhythm, body position, and snoring intensity.
Your physician will recommend the appropriate test based on your symptoms, medical history, and the level of detail needed for an accurate diagnosis.
The Role of Dentist vs. Sleep Physician
Sleep apnea care involves a team approach. A board-certified sleep physician orders and interprets your sleep study, makes the formal diagnosis, determines severity, and prescribes treatment. Dr. Chan serves as your dental sleep medicine provider — screening for risk factors during routine dental exams, facilitating referrals for testing, and providing oral appliance therapy once a diagnosis is confirmed.
Dr. Chan also screens for TMJ disorders that may affect appliance selection, monitors your dental health throughout treatment, and coordinates follow-up sleep testing to verify your appliance is effectively treating your sleep apnea.
Understanding Your Results: AHI Scores
The Apnea-Hypopnea Index (AHI) represents the average number of apnea and hypopnea events per hour of sleep. Your score determines severity and treatment approach.
Normal: AHI Below 5
Fewer than 5 breathing disruptions per hour. Considered within the normal range, though some patients with an AHI between 1 and 5 may still benefit from treatment if symptoms are significant.
Mild: AHI 5 to 15
5 to 15 events per hour. Many patients experience noticeable daytime fatigue, disruptive snoring, and reduced concentration. Oral appliance therapy is often the first-line treatment.
Moderate: AHI 15 to 30
15 to 30 events per hour. The health risks become significantly more pronounced at this level. Both CPAP and oral appliance therapy are effective options.
Severe: AHI Above 30
More than 30 events per hour. Carries the highest cardiovascular, metabolic, and cognitive risks. CPAP is typically the primary recommendation, though oral appliances may suit CPAP-intolerant patients.
What Tests Measure
Sleep studies record apneas (complete airflow cessation for 10+ seconds) and hypopneas (partial airflow reduction of 30%+ with oxygen drops). Additional data includes oxygen patterns and heart rate variability.
After Diagnosis: Next Steps
Dr. Chan takes detailed impressions to fabricate a custom oral appliance. A follow-up sleep study confirms the appliance is effectively reducing your AHI to a healthy range.
Insurance Coverage & Practical Information
Generally covered with lower out-of-pocket costs. Many plans cover HST at 80-100% after your deductible is met.
Covered by most plans but costs more and may require prior authorization. Some insurers require a home sleep test first.
Most insurers require a referral from your primary care physician or sleep specialist before authorizing a sleep study.
Often covered under medical insurance rather than dental insurance, since it treats a medical condition. Coverage varies by plan.
Frequently Asked Questions About Sleep Apnea Diagnosis & Testing
How long does a home sleep test take?
A home sleep test is typically worn for one to three nights. Most insurance companies and sleep physicians require at least one full night of recorded data to make a diagnosis. The device is small, portable, and relatively unobtrusive, so most patients find they can sleep reasonably well while wearing it. You will receive detailed instructions on how to apply the sensors before bedtime and remove them in the morning. Results are usually available within one to two weeks after the data is reviewed by a board-certified sleep physician.
Can a dentist diagnose sleep apnea?
No. A dentist cannot formally diagnose sleep apnea — only a physician or board-certified sleep specialist can make the official diagnosis based on sleep study results. However, dentists trained in dental sleep medicine like Dr. Chan play a critical role in screening patients for sleep apnea risk, identifying anatomical factors such as a narrow airway or recessed jaw, referring patients for testing, and providing oral appliance therapy once a diagnosis has been established. Dr. Chan works directly with your sleep physician to ensure coordinated care.
What is the difference between AHI and RDI?
AHI (Apnea-Hypopnea Index) counts the number of complete breathing cessations (apneas) and partial airway blockages (hypopneas) per hour of sleep. RDI (Respiratory Disturbance Index) is a broader measurement that includes apneas, hypopneas, and respiratory effort-related arousals (RERAs) — events where breathing becomes labored enough to disrupt sleep but does not meet the full criteria for an apnea or hypopnea. Because RDI captures more events, it is often a higher number than AHI for the same patient. Both metrics help determine the severity of your sleep-disordered breathing.
Will my insurance cover a sleep study?
Most medical insurance plans cover sleep studies when they are deemed medically necessary. A referral from your primary care physician or sleep specialist is typically required. Home sleep tests are generally covered at a higher rate than in-lab polysomnography because they cost significantly less. Many plans require prior authorization before testing. Our team can help you understand your coverage and navigate the referral process so you can get tested with minimal out-of-pocket expense.
What happens if my home sleep test results are inconclusive?
If a home sleep test produces inconclusive results — for example, the data quality was poor due to the sensors shifting during sleep, or the results are borderline — your sleep physician may recommend a second home sleep test or an in-lab polysomnography for more comprehensive data. In-lab studies provide a higher level of detail because a technician monitors you throughout the night and can adjust sensors as needed. An inconclusive result does not mean you do not have sleep apnea; it simply means more data is needed to make a confident diagnosis.
Do I need a new sleep study if I was diagnosed years ago?
Sleep physicians generally recommend updated testing if your original diagnosis was more than five years ago, if your symptoms have changed significantly, if you have gained or lost a substantial amount of weight, or if your current treatment no longer seems effective. Sleep apnea severity can change over time due to aging, weight fluctuations, and other health changes. An updated sleep study ensures your current treatment plan is appropriate for your current level of sleep-disordered breathing.
