Obstructive Sleep Apnea ICD 10 Code

Content reviewed by Megan Andrews, MSN, APRN, ANP-Cs

Obstructive sleep apnea (OSA) is a common sleep disorder in which the muscles of the throat intermittently relax during sleep, causing the airway to become partially or completely blocked. This blockage results in pauses in breathing (apneas) that disrupt sleep, leading to reduced oxygen levels, frequent awakenings, and poor sleep quality. OSA can have serious health consequences if left untreated, including increased risk for cardiovascular disease, stroke, and daytime fatigue. 

What is obstructive sleep apnea? 

Obstructive sleep apnea involves repetitive episodes of airway obstruction during sleep, often accompanied by loud snoring, gasping, or choking sounds. These episodes lead to disrupted sleep patterns, poor oxygenation, and excessive daytime sleepiness. OSA is most commonly seen in individuals who are overweight or obese, though it can affect people of all body types and ages. 

Symptoms of OSA 

• Loud, frequent snoring 
• Episodes of gasping or choking during sleep 
• Observed pauses in breathing  
• Daytime fatigue or excessive sleepiness (hypersomnia) 
• Morning headaches 
• Difficulty concentrating or memory problems 
• Irritability or mood changes 
• Dry mouth or sore throat upon waking 

Risk factors for OSA 

• Obesity or excessive body weight 
• Large neck circumference 
• Enlarged tonsils or adenoids (especially in children) 
• Smoking 
• Alcohol use or sedative medications 
• Male gender (though it also affects female patients, especially after menopause) 
• Family history of OSA 

ICD-10 code for obstructive sleep apnea  

The ICD-10 code for obstructive sleep apnea helps clinicians and healthcare professionals document and manage this condition effectively, facilitating treatment planning and reimbursement. 

G47.33 – Obstructive sleep apnea (adult) (pediatric) 

Definition: This code is used for diagnosing obstructive sleep apnea in both adults and pediatric patients. It refers to the partial or complete collapse of the airway during sleep, resulting in breathing pauses and decreased oxygen levels. OSA is diagnosed through sleep studies, such as polysomnography. 

Nursing application: Nurses caring for patients with obstructive sleep apnea should focus on patient education, symptom management, and promoting adherence to treatments, such as continuous positive airway pressure (CPAP) therapy. Nursing interventions may include providing guidance on lifestyle changes, assisting with the use of CPAP or other airway devices, and monitoring for signs of complications, such as cardiovascular issues or excessive daytime sleepiness. 

Nursing interventions for obstructive sleep apnea 

Effective nursing care for obstructive sleep apnea involves a combination of patient education, management of sleep-disordered breathing, and collaboration with healthcare providers to ensure the patient’s overall health and quality of life are improved. 

1. Patient assessment and monitoring 

A thorough assessment of patients’ sleep patterns, medical history, and risk factors is critical in developing individualized care plans for OSA. Nurses should assess for signs of OSA, including snoring, witnessed apneas, daytime sleepiness, and any associated comorbidities, such as hypertension or heart disease. 

Application: During the patient’s initial assessment, nurses should ask about their sleep habits, breathing difficulties during sleep, and the presence of risk factors such as obesity or a large neck circumference. Additionally, nurses should monitor for symptoms of daytime fatigue, cognitive impairments, or mood changes, which are often related to poor sleep quality in OSA patients. 

2. CPAP therapy management 

CPAP therapy is considered the gold standard treatment for obstructive sleep apnea. CPAP devices deliver constant air pressure through a mask to keep the airway open during sleep, preventing apneas and improving oxygen levels. 

Application: Nurses should educate patients on the proper use of CPAP machines, including mask fitting, cleaning the device, and adjusting the air pressure as needed. Nurses can help patients overcome common barriers to CPAP use, such as discomfort with the mask, dry mouth, or nasal congestion, by providing solutions like heated humidifiers or nasal sprays. Encouraging adherence to CPAP therapy is critical, as inconsistent use reduces the treatment’s effectiveness. 

3. Encouraging weight management 

Obesity is one of the most significant risk factors for obstructive sleep apnea, as excess weight around the upper airway can contribute to airway obstruction. Nurses can play an important role in helping patients develop weight loss strategies to reduce the severity of OSA. 

Application: Nurses should work with patients to create achievable goals for weight management, including providing education on healthy eating, portion control, and the benefits of regular physical activity. Collaborating with dietitians and exercise specialists can provide additional support. Even modest weight loss can substantially lessen the frequency and severity of apneas, improving overall health and sleep quality. 

4. Promoting good sleep hygiene 

Patients with OSA often experience disrupted sleep patterns due to frequent awakenings and apneas. Educating patients about proper sleep hygiene can help improve their sleep quality and reduce the impact of OSA. 

Application: Nurses should teach patients the importance of establishing a regular sleep schedule, creating a comfortable sleep environment, and limiting the use of electronic devices before bedtime. Avoiding stimulants such as caffeine and alcohol, particularly in the evening, can also help improve sleep quality. Nurses should encourage patients to sleep on their sides, as sleeping on the back can worsen OSA by allowing the tongue and soft tissues to obstruct the airway. 

5. Managing comorbid conditions 

Patients with obstructive sleep apnea often have comorbid conditions such as hypertension, diabetes, or cardiovascular disease. Managing these conditions is essential to reduce the overall health risks associated with OSA. 

Application: Nurses should collaborate with healthcare providers to monitor and manage the patient’s comorbidities, ensuring that conditions like hypertension are controlled through medications or lifestyle modifications. Nurses can also provide education on the importance of managing blood sugar levels, especially for patients with diabetes, as poor control can worsen OSA symptoms. 

6. Surgical interventions and alternatives 

In cases where CPAP therapy is not effective or tolerated, surgical interventions or alternative treatments may be considered. These options include uvulopalatopharyngoplasty (UPPP), nasal surgeries, or the use of dental appliances. 

Application: Nurses should inform patients about the potential surgical options available for treating OSA and help them understand the risks and benefits of each procedure. For patients using oral appliances, such as mandibular advancement devices (MADs), nurses should provide instructions on proper usage and care. Post-operative care for surgical interventions includes monitoring for complications, such as infection or difficulty swallowing. 

7. Addressing psychological and emotional well-being 

Living with OSA can impact a patient’s psychological and emotional well-being, especially if they experience chronic fatigue, frustration with treatment adherence, or anxiety about their health. Nurses should provide emotional support and refer patients to mental health services if necessary. 

Application: Nurses should assess patients for signs of depression or anxiety related to their sleep disorder and provide reassurance about the effectiveness of treatment. Encouraging patients to share their experiences and frustrations with their care team can help reduce feelings of isolation. Connecting patients with support groups or online communities can offer additional emotional support. 

Preventing complications in obstructive sleep apnea: The nurse’s role 

Obstructive sleep apnea can lead to several complications, including cardiovascular disease, stroke, diabetes, and accidents related to daytime sleepiness. Nurses help prevent these complications through early intervention, patient education, and consistent monitoring. 

Key preventative measures include: 

1. Promoting CPAP adherence: Nurses should emphasize the importance of using CPAP therapy consistently to prevent complications like high blood pressure, heart failure, or stroke. Regular follow-up visits to assess the patient’s progress and address any issues with CPAP use are critical for long-term success. 
2. Monitoring for cardiovascular complications: OSA increases the risk of hypertension, arrhythmias, and heart disease. Nurses should monitor blood pressure and heart rate during routine assessments and educate patients on the importance of controlling these risk factors through lifestyle changes and medications. 
3. Preventing accidents from daytime sleepiness: Patients with untreated OSA often experience excessive daytime sleepiness, putting them at risk for motor vehicle accidents or workplace injuries. Nurses should educate patients about the risks of driving or operating heavy machinery when drowsy and encourage them to report excessive sleepiness to their healthcare provider. 
4. Educating on healthy lifestyle changes: Nurses can support patients in making healthier lifestyle choices that reduce OSA symptoms and prevent complications. These changes include weight loss, smoking cessation, reducing consumption of alcohol, and increasing physical activity.