Sleep Apnea: Severity Assessment at Initial Diagnosis
Percentage of patients aged 18 years and older with a diagnosis of obstructive sleep apnea who had an apnea hypopnea index (AHI), a respiratory disturbance index (RDI), or a respiratory event index (REI) documented or measured within 2 months after initial evaluation for suspected obstructive sleep apnea.
Last updated: January 15, 2026
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📖Clinical Rationale
The severity of OSA must be established in order to make an appropriate treatment decision. For patients with obstructive sleep apnea (OSA), treatment selection and implementation are dependent on the severity of the disease. Physicians treating patients with OSA should calculate the patient’s level of severity, which informs risk for other co- morbid conditions and complications.
Clinically, the apnea-hypopnea index (AHI) provides cutpoints that can be used to establish the diagnosis and severity of OSA and evaluate treatment effect. OSA severity is graded depending on the AHI. Mild OSA with AHI of 5 to <15, moderate with AHI of 15 to 30 and severe with AHI of >30. Patients with a respiratory disturbance index equal to or greater than 15 are considered to have moderate to severe OSA and should be treated with OSA therapy.
📝Clinical Recommendations
The Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea recommends that polysomnography, or home sleep apnea testing with a technically adequate device, be used for the diagnosis of OSA in uncomplicated adult patients presenting with signs and symptoms that indicate an increased risk of moderate to severe OSA (Kapur et al, 2017).
Mild, moderate and severe OSA are defined according to following criteria in adults: mild, RDI 5 to ≤15; moderate, RDI 15 to 30; and severe, RDI >30 (Kushida et al, 2008). Treatment success is usually defined as a reduction in the AHI/RDI/REI to a specific level (e.g., post-treatment AHI/RDI/REI < 5, > 50% reduction in AHI/RDI/ REI) (Ramar et al, 2015).
The severity of OSA is determined by an index – Apnea Hypopnea Index (AHI) or Respiratory Disturbance Index (RDI), if PSG is performed, or Respiratory Event Index (REI) if out-of-center-sleep testing (OCST) is performed (Goyal et al, 2017).
📋Implementation Notes
This measure contains one strata defined by a single submission criteria. This measure produces a single performance rate. For the purposes of MIPS implementation, this episode measure is submitted each time a patient has a denominator eligible encounter during the performance period.
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