DATE OF STUDY: MM/DD/YYYY
INDICATION FOR STUDY: Daytime somnolence, excessive sleepiness during the daytime, and fatigue.
FINDINGS: The total recording time was 479.4 minutes and total sleep time was 426 minutes. Sleep efficiency was 91%. Latency to sleep onset was 1.5 minutes. Latency to REM sleep was 104 minutes. Number of awakenings was 14. Time awake after sleep onset was 41. Sleep percentages showed awake time was 42.5 minutes or 8.9% of total. Stage I was 97.6 minutes of total or 22.9% of total. Stage II was 206 minutes or 48.4% of total. Stage III and IV were 61 minutes or 14.3% of total.
Cardiopulmonary parameters showed a heart rate of 56 during awake and 52 during sleep and a respiratory rate of 18 during awake and 14 during sleep. Periodic leg movements were 23 with no arousals and the PLMS index was 3.2 per hour. Arousal index was 0 per hour.
Respiratory data showed total number of apneas and hypopneas of 9, number of apneas 3 and number of hypopneas 6. Apnea index was 0.4 per hour and apnea-hypopnea index was 7.3 per hour. Arousal index was 0.7 per hour. There were no REM events. Desaturation profile showed 3 events with O2 saturation between 50-55%, 3 events with O2 saturation between 55-60%, 2 events with O2 saturation between 60-65%, 3 events with O2 saturation between 65-70%, 3 events with O2 saturation between 70-75%, 1 event with O2 saturation between 75-80%, 5 events with O2 saturation between 80-85%, 15 events with O2 saturation between 85-90%, 41 events with O2 saturation between 90-95%, and 1 event with O2 saturation above 95%.
The longest respiratory event was 21.4 seconds and the lowest desaturation was 24%. There was 1 event with O2 saturation between 30-35% and 1 event with O2 saturation less than 30%. There was no snoring during the night.
The patient’s Epworth sleepiness scale was reported to be 4/24.
IMPRESSION:
1. Normal sleep architecture.
2. No obstructive or central sleep apnea.
3. Severe desaturation during the night, which explains the patient’s fatigue during the morning.
Because of the patient’s severe desaturation, that goes down to 24%, which is life threatening, the patient may benefit from CPAP and additional oxygenation. Oxygen alone may not prevent the severe desaturation. We recommended that the patient have repeat study initially with oxygen and if needed CPAP will be added.
DATE OF STUDY: MM/DD/YYYY
INDICATION FOR STUDY: Increasing daytime sleepiness and increasing fatigue, snoring during the night with sleep apnea.
FINDINGS: The total recording time was 529.6 minutes and total sleep time was 474 minutes with sleep efficiency now 91%. Latency to sleep onset was 10.5 minutes and latency to REM was 0. Number of awakenings was 8 and awake after sleep onset was 26.5. Sleep percentages showed awake time was 37 minutes or 7% of total. Stage I was 460.5 minutes or 96.9% of total. Stage II was 8.5 minutes or 1.8% of total. Stage III and IV were 5.5 minutes or 1.2% of total. REM stage was 0.
Cardiopulmonary parameters showed heart rate was 62 during awake and 70 during sleep. Respiratory rate was 18 during awake and 24 during sleep.
Periodic leg movements were 730 but no arousals recorded. Periodic leg movement index was 92.2 per hour.
Respiratory data showed total number of apneas and hypopneas of 428. Number of apneas was 179 and number of hypopneas was 249. Apnea index was 22 per hour and apnea-hypopnea index was 54.1 per hour. Arousal index was 20.6 per hour. There were no REM events.
Desaturation profile showed O2 saturation 75-80% 17 times. There was only 451 times with O2 saturation between 80-85%, 187 times with O2 saturation between 85-90%. The lowest desaturation was 58% and the longest respiratory event was 42 seconds. Snoring was recorded to be between 2-6/10.
IMPRESSION:
1. Disturbed sleep pattern.
2. Severe periodic leg movements.
3. Severe obstructive sleep apnea with multiple arousals during the night.
4. Mild to moderate desaturation during the night.
The patient will benefit from CPAP trial, with or without supplemental oxygen.
