Rating Scales for Obstructive Sleep Apnea Syndrome - The Importance of a Comprehensive Assessment

Sep 29, 2026

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Obstructive sleep apnea syndrome (OSAS) features cyclical apnea during sleep driven by altered pharyngeal and tongue dilatory muscle function. Often underestimated, OSAS can impair health and quality of life and is linked to multiple systemic diseases. Clinical presentations vary and may coexist with comorbidities, making differentiation and early diagnosis challenging. This narrative review evaluates existing OSAS assessment and classification rating scales and briefly addresses related pathologies, emphasizing that early detection supports timely intervention and helps prevent progression of pre-existing conditions.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages16

Reading Time40 min

AccessFree to download

Introduction And Background

Sleep-disordered breathing and OSAS prevalence

Historical classification and diagnostic criteria

Clinical consequences of OSAS

Respiratory event definitions and AHI severity

Assessment and treatment overview

CPAP and nonpharmacological options

Oral and nasal devices

Review began 12/30/2025 Review ended 12/31/2025 Published 01/04/2026 © Copyright 2026 Bordoni et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited. DOI: 10.7759/cureus.100725 Open Access Review Article Rating Scales for Obstructive Sleep Apnea Syndrome: The Importance of a Comprehensive Assessment Bruno Bordoni 1 , Bruno Morabito 2 1. Physical Medicine and Rehabilitation, Foundation Don Carlo Gnocchi, Milan, ITA 2. Faculty of Medicine, Università Cattolica del Sacro Cuore Agostino Gemelli University Hospital, Rome, ITA Corresponding author: Bruno Bordoni, [bordonibruno@hotmail.com](bordonibruno@hotmail.com) Abstract Obstructive sleep apnea syndrome (OSAS) is characterized by cyclical apnea states during sleep, caused by alterations in the dilatory muscles of the pharynx and tongue. It is an underestimated and underappreciated disorder, which can affect a person 's health and quality of life, as well as trigger the onset of several other systemic diseases. Patients diagnosed with OSAS present with clinical pictures that are not always easy to distinguish and may be associated with multiple comorbidities. This heterogeneity makes early diagnosis difficult and complicates not only the resolution of sleep apnea but also the balancing of clinical priorities. Various OSAS assessment and classification scales exist in the literature, as early diagnosis is essential for more effective treatment. This narrative review article reviews the assessment scales for OSAS and briefly discusses the pathologies that may be encountered in the presence of this syndrome. Early detection of OSAS not only means early clinical intervention but also means preventing pre-existing pathologies from worsening. Categories: Osteopathic Medicine, Physical Medicine & Rehabilitation, Palliative Care Keywords: continuous positive airway pressure, cpap, diaphragm, obstructive sleep apnea syndrome, osas, rating scale, sleep-disordered breathing, tongue Introduction And Background Sleep-disordered breathing (SDB) includes several disorders, such as obstructive sleep apnea syndrome (OSAS), primary snoring, Cheyne-Stokes respiration, central sleep apnea (CSA), sleep-related hypoventilation, and hypoxemia [1] . The most common is OSAS, where functional and structural alterations of the pharyngeal airways cause intermittent apneas, hypopneas, and hypoxia, limiting airflow and preventing proper nighttime rest [2] . It is estimated that approximately one billion people may suffer from OSAS, approximately a third of whom are adults [3] . Historically, OSAS was only classified in 1965. According to the International Consensus Statement on Obstructive Sleep Apnea: “It is defined on the basis of nighttime and daytime symptoms as well as objective data from a sleep study (home sleep apnea test or polysomnography)” [4] . Furthermore, approximately 50% of patients suffer from excessive daytime sleepiness (EDS) [5] . Constant and chronic sleep disruption causes various consequences for the person who suffers from it. OSAS induces alterations in saturation (hypercarbia, hypoxemia), increases systemic oxidative stress, and stimulates the presence of sympathetic hyperactivity [5] . In the long term, OSAS contributes to the onset of multiple disorders and pathologies. Patients may suffer from daytime drowsiness and general fatigue, with less attention in daily and work activities. A negative alteration of memory, cognitive decline, and fluctuations in mood and emotional status are recorded, which can lead to psychological and psychiatric problems [5,6] . There is a bidirectionality between OSAS and the presence of cardiovascular (congestive heart failure), neurological (stroke, dementia), metabolic (obesity, diabetes), oncological and nephrologica

FAQs

Why is early diagnosis of obstructive sleep apnea syndrome (OSAS) difficult?

OSAS presentations can be heterogeneous and may be difficult to distinguish from other conditions, often accompanied by multiple comorbidities. This variability complicates early recognition and affects clinical prioritization.

What measurements are used to define OSAS severity?

Apnea and hypopnea events are defined using established respiratory disturbance criteria, with polysomnography as the gold standard. The apnea-hypopnea index (AHI) is calculated from these events and hours of sleep to estimate severity.

What are first-line non-surgical treatment approaches mentioned for OSAS?

Continuous positive airway pressure (CPAP) is identified as the gold standard nonpharmacological and non-surgical first-line therapy. The review also mentions oral aids such as tongue retaining devices (TRD) and mandibular repositioning devices (MRD), along with nasal breathing support devices.

Sep 29, 2026

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