Sleep Study

Note Type: Sleep Study
Care Provider: [omitted] Clinic: [omitted]
Transcribed By: [omitted]

[omitted]
[omitted]
Medical Record Reports

Company: [omitted] MRN: [omitted]
Prov Code: [omitted] Pt Name: [omitted]
Prov Name: [omitted] Note Type: CPSG
OD: 09/19/2007 Visit Date: 09/17/2007
OT: 09/20/2007 Site Code: [omitted]
Dictate Time: 15:38:00 Dept Code: 00
Trans CO:[omitted] Trans Init: [omitted]

Split Study Interpretation

Indications For The Study: Snoring, daytime sleepiness, and possible positive case of obstructive sleep apnea.

Polysomnography Interpretation

  1. The patient has severe case of obstructive sleep apnea with 11.6 events of apnea-hypopnea during the study, with an index of 81.3 events per hour.
  2. The patient has multiple arousable and sleep fragmentation related to the respiratory events.
  3. The patient has a sleep latency of 11.6 minute with sleep efficiency of 81.3%
  4. EKG channel demonstrated a normal sinus rhythm.
  5. EMG channel demonstrated no periodic limb movement.
  6. Lowest saturation during study was 65%.
  7. Loud snoring was recorded during the study.
  8. Due to the severity of apnea-hypopnea, CPAP titration was started in the second half of the night.

CPAP Titration Interpretation

  1. CPAP with pressure 12 cm is optimal pressure in this patient to eliminate the majority of the apnea-hypopneas.
  2. The patient has significant recovery in the sleep fragmentation and arousal.
  3. The patient has good restoration of sleep architecture.
  4. The patient has a sleep latency of 5.8 minutes with sleep efficiency of 97.3%
  5. EKG channel demonstrated normal sinus rhythm.
  6. EMG channel demonstrated no periodic limb movement.
  7. Lowest saturation during study was 81%, and with CPAP at pressure of 12 cm, the average saturation was 94%.

Further recommendation in term of weight reduction also recommended.

[omitted] M.D.
[omitted]
[omitted]
[omitted]

Page 1

[omitted]

Sleep Disorders Center

Polysomnography Clinical Report

PATIENT INFORMATION

Patient: [omitted] Test Date: 9/17/2007
Age: 48 [omitted] Weight: [omitted]
ID# [omitted] Sex: F

SUMMARY OF SLEEP PARAMETERS

Lights Off Time: 10:40:11 PM Total Study Time (TIB): 2.4 Hours
Total Sleep Time (TST): 2.0 Hours Sleep Efficiency%: 81.3%

LATENCIES

Latency to First Epoch of Sleep 11.6
Latency to Sleep Onset: 11.6
Latency to Stage REM: 46.5
Number of Awakenings 1
Number of Arousals: 19

SLEEP STAGES

Stage Wake ---
Stage 1 3.4
Stage 2 88.5
Stage 3-4 0.0
Stage REM 8.1

 

RESPIRATORY SUMMARY # of Events Index/Hr
Obstructive Apnea 70 35.0
Central Apnea 31 15.8
Mixed Apnea 3 1.5
Hypopnea 15 7.7
Central Hypopnea 0 0.0
Obstructive Hypopnea 0 0.0
Apnea + Hypopnea 119 60.0

 

Heart Rate Mean HR High HR Low Hr
Awake 83.1 91.0 68.0
Rem 78.7 90.0 75.0
Non Rem 80.3 89.0 69.0
Sleep 80.2 90.0 69.0

PERIODIC MOVEMENTS

PLM 0
PLM Idex 0.0
PLM Arousal Index 0.0

OXIMETRY

Desaturations Total #: 39
Mean Duration 24.0 seconds
Lowest SaO2 65.0%
Time SaO2 below 85% 20.9 minutes

Page 2

[omitted]

Sleep Disorders Center

Polysomnography Clinical Report

PATIENT INFORMATION

Patient: [omitted] Test Date: 9/18/2007
Age: 48 [omitted] Weight: [omitted]
ID# [omitted] Sex: F

SUMMARY OF SLEEP PARAMETERS

Lights Off Time: 1:24:24 Total Study Time (TIB): 4.0 Hours
Total Sleep Time (TST): 3.9 Hours Sleep Efficiency%: 97.3%

LATENCIES

Latency to First Epoch of Sleep 5.8
Latency to Sleep Onset: 5.8
Latency to Stage REM: 61.0
Number of Awakenings 1
Number of Arousals: 3

SLEEP STAGES

Stage Wake ---
Stage 1 1.9
Stage 2 37.2
Stage 3-4 0.0
Stage REM 60.9

 

RESPIRATORY SUMMARY # of Events Index/Hr
Obstructive Apnea 4 1.0
Central Apnea 7 1.8
Mixed Apnea 0 0.0
Hypopnea 4 1.0
Central Hypopnea 0 0.0
Obstructive Hypopnea 0 0.0
Apnea + Hypopnea 15 3.8

 

Heart Rate Mean HR High HR Low Hr
Awake 83.1 90.0 73.0
Rem 72.3 85.0 64.0
Non Rem 76.3 82.0 59.0
Sleep 73.9 85.0 59.0

PERIODIC MOVEMENTS

PLM 0
PLM Idex 0.0
PLM Arousal Index 0.0

OXIMETRY

Desaturations Total #: 1
Mean Duration 17.3 seconds
Lowest SaO2 81.0%
Time SaO2 below 85% 1.3 minutes

Page 3

Tech Notes

Sleep Study

  1. Apneas Rem related

  2. Pt has closed head injury. 1980 see pt info for details of accident.

  3. Pt desat to 65% -- split study

Titration

Final Cpap Pressure 12 cm H2O Mask: Comfort Classic Size: Small
  1. Started pt @ 5cm. Pt asked to raise pressure. Incr to 6cm. Continued to increase pressure until pt adapted which too about 1hr 20min.
  2. Finally lying pressure in C-Flex mode @ 12/8.
  3. Pt immediately in Rem - above 81% SaO2.

End