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Sleep Apnea
Designed for a 60-second scan in primary care. Use this to explain why this theory fits, what would weaken it, and which tests are most worth discussing.
Why this still fits
I have persistent morning brain fog that improves through the day, unrefreshing sleep despite adequate hours, and [snoring/partner observations]. My STOP-BANG score is [X] and Epworth is [Y]. I'd like a sleep study referral.
What would weaken it
- -Is your fog worst in the morning and clearly improves as the day goes on?
- -Do you snore loudly or has anyone told you that you stop breathing while sleeping?
- -Do you crash 12-72 hours AFTER exertion (not just feel tired during/after)?
- -Did a negative home sleep test leave the story unresolved because UARS or mild arousal-based disease is still plausible?
Key points to communicate
- •80% of moderate-severe OSA is undiagnosed
- •My fog follows the classic morning-worst pattern of OSA
- •I'd prefer in-lab polysomnography to catch UARS if possible
- •Please separate metabolic, sleep, autonomic, and medication overlap before narrowing to one cause.
Tests and measurements to discuss
Need the fuller context? Use the test explainers for the measurement itself, or jump back to the tests section on the Sleep Apnea page to see how the tests fit the whole pattern.
In-Lab Polysomnography
What this helps clarify: Gold standard for sleep apnea diagnosis
Range context
AHI <5
How to use the result
Ask for AHI, oxygen nadir, arousal index, and REM-specific findings.
Home Sleep Test
What this helps clarify: This is here to make sure the story is not being driven by sleep-disordered breathing or chronic sleep disruption that only looks like ADHD on bad days.
Ferritin
What this helps clarify: Iron storage marker that can affect energy, focus, and cognition.
Range context
40-100 ng/mL
How to use the result
Save the result with date and symptoms from the same week.
Thyroid panel (TSH, Free T4)
What this helps clarify: Thyroid hormone precursor — low levels indicate hypothyroidism
Range context
1.0–1.5 ng/dL
How to use the result
Save the result with date and symptoms from the same week.
Medication review for sedatives, opioids, antihistamines, and alcohol timing
What this helps clarify: Identify fog-causing meds: benzos, anticholinergics, etc.
Range context
Pharmacist consultation
How to use the result
Save the result with date and symptoms from the same week.
Peer-reviewed references