CPAP TITRATION STUDY MEDICAL TRANSCRIPTION EXAMPLE
DATE OF TEST: MM/DD/YYYY
REFERRING PHYSICIAN: John Doe, MD
TEST PERFORMED: CPAP titration.
PROCEDURE: The overnight polysomnogram was performed recording the EEG, EOG, chin and leg EMG, EKG, respiratory airflow, thoracic and abdominal effort, and oximetry.
INDICATION FOR TEST: The patient is a (XX)-year-old woman with previously diagnosed obstructive sleep apnea who presents for a repeat CPAP titration at this time.
TEST INTERPRETATION: A CPAP titration was performed in the usual fashion. Total time in bed was 397 minutes with a total sleep time of 322 minutes resulting in a mildly reduced sleep efficiency of 81%.
Latency to sleep onset was normal at 11.5 minutes with a severely reduced REM latency of 20.5 minutes. All stages of sleep were identified during the study, though REM sleep was significantly reduced at 13.4% of total sleep time. Slow wave sleep was found in adequate amounts at 17.4% of total sleep time. CPAP was used at varying levels of pressure ranging from 4-9 cm water. The most optimal CPAP setting appears to be 8 cm water at which time REM sleep was encountered in the supine position, and the apnea-hypopnea index was 0.0. At this level of pressure, there was no snoring noted and no hypoxia encountered with SaO2 low of 92%.
The periodic limb movement index was normal at 2.4 which fell to 0.91 index with arousals. There were no significant cardiac arrhythmias identified during the study though the patient did have sinus bradycardia in the 50s.
IMPRESSION:
1. Obstructive sleep apnea.
2. Severely reduced REM latency is consistent with REM rebound.
3. Significantly reduced quantity of REM sleep was consistent with sleep disruption due to significant obstructive sleep apnea.
RECOMMENDATIONS:
1. Suggest nasal CPAP at 8 cm water via a ResMed Mirage FX for Her mask with heated humidification.
2. Weight loss to ideal body weight is strongly encouraged.
3. Avoid alcohol, sedatives, and hypnotics, as these may exacerbate obstructive sleep apnea.
