Diagnostic criteria

(A and B) or C satisfy the criteria

A) The presence of one or more of the following:

1. The patient complains of sleepiness, nonrestorative sleep, fatigue, or insomnia symtoms.

2. The patient wake with breath holding, gasping, or choking.

3. The bed partner or other observer reports habitual snoring, breathing interruptions, or both during the patient’s sleep.

4. The patient has been diagnosed with hypertension, a mood disorder, cognitive dysfunction, coronary artery disease, stroke, congestive heart failure, atrial fibrillation, or type 2 diabetes mellitus.

B) Polysomnography (PSG) or out of center sleep testing (OCST) demonstrates:

1. Five or more predominantly obstructive respiratory events (obstructive and mixed apneas, hypopneas, or respiratory effort related arousal (RERAs) per hours of sleep during a PSG or per hours of monitoring (OCST).


C) PSG or OCST demonstrates:

1. Fifteen or more predominantly obstructive respiratory events (apneas, hypopneas, or RERAs) per hour of sleep during a PSG or per hour of monitoring (OCST).


1. OCST commonly underestimates the number of obstructive respiratory event per hour as compared to PSG because actual sleep time, as determined primarily by EEG, is often not recorded. The term respiratory event index (REI) may be used to denote event frequency based on monitoring time rather than total sleep time.

2. Respiratory events defined according the latest version of the AASM Manual for the Scoring of Sleep and Associated Events.

3. RERAs and hypopneas events based on arousal from sleep cannot be scored using OCST because arousals by EEG criteria cannot be identified.