What is included in a polysomnography (PSG) report?

Updated: Apr 29, 2020
  • Author: Carmel Armon, MD, MSc, MHS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Answer

Standard analysis still consists of reviewing each of the parameters recorded. Overnight parameters (eg, times of lights on/off, total time in bed, total sleep time, sleep latency, REM latency) are collected. The overnight recording is divided into epochs of approximately 30 seconds. The standard EEG, EMG, and EOG recordings are evaluated, and the predominant stage of sleep (according to the AASM 2007 scoring manual) is then assigned to the entire epoch.  In 2015, the AASM changed the recommended scoring criteria of most events including now recommending using 3% desaturation or arousal for criteria for hypopneas. Medicare guidelines, however, still use the not-recommended 4% desaturation criteria that can miss many patients with signficant obstructive sleep apnea.

Total time and relative proportion of the night spent in each of the stages and in REM and non-REM sleep are calculated. Latencies to REM and slow-wave sleep are reported.

Stages of sleep, any abnormalities noted with EEG, and periodic limb movements are reported. Respiratory activity (eg, apneic or hypopneic episodes, oxygen desaturations) is correlated with sleep stages. Other parameters, such as body position, are recorded. If needed, esophageal pH or penile tumescence can also be recorded.

Once sleep apnea is diagnosed with either a portable limited-channel stud or an in-laboratory PSG, a patient can either be started with autotitrating CPAP at home or an in-laboratory titration study can be done. In-laboratory titration is recommended if there are other breathing disorders than obstructive sleep apnea, including hypopnea, hypoventilation, or central sleep apnea, as devices other than CPAP are often needed.


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