Which diagnosis best fits duration, episodicity, and exclusions?
A
Obstructive sleep apnoea-hypopnoea
Evidence by polysomnography of ≥5 obstructive apnoeas/hypopnoeas per hour of sleep + ≥1 of: nocturnal breathing disturbances (snoring, snorting, gasping, breathing pauses); daytime sleepiness/fatigue/unrefreshing sleep not explained by another disorder; OR ≥15 obstructive apnoeas/hypopnoeas per hour of sleep regardless of accompanying symptoms
Self-reported excessive sleepiness (hypersomnolence) despite main sleep period of ≥7 hrs; ≥1 of: recurrent lapses into sleep during same day; prolonged main sleep episode (>9 hrs) that is non-restorative; difficulty being fully awake after abrupt awakening
AA. Evidence by polysomnography of ≥5 obstructive apnoeas/hypopnoeas per hour of sleep + ≥1 of: nocturnal breathing disturbances (snoring, snorting, gasping, breathing pauses); daytime sleepiness/fatigue/unrefreshing sleep not explained by another disorder; OR ≥15 obstructive apnoeas/hypopnoeas per hour of sleep regardless of accompanying symptoms
BA. Self-reported excessive sleepiness (hypersomnolence) despite main sleep period of ≥7 hrs; ≥1 of: recurrent lapses into sleep during same day; prolonged main sleep episode (>9 hrs) that is non-restorative; difficulty being fully awake after abrupt awakening B. Hypersomnolence occurs ≥3×/week for ≥3 months C. Accompanied by significant distress or impairment
Common specifiers
AMild; Moderate; Severe
BAcute; Subacute; Persistent; Mild
Differential flags
ACentral sleep apnoea (different respiratory events; different mechanism); Primary insomnia (no respiratory events; no excessive daytime sleepiness); Hypersomnolence disorder (no respiratory events on PSG)