SLEEP-DISORDERED BREATHING DIAGNOSIS AND TREATMENTkapak

EVALUATION OF POLYSOMNOGRAPHY REPORTS

Öznur Gündüz

Akdağmadeni State Hospital, Department of Otorhinolaryngology, Yozgat, Türkiye

Gündüz Ö. Evaluation of Polysomnography Reports. In: Özcan KM, editor. Sleep-Disordered Breathing: Diagnosis and Treatment. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.85-96.

ABSTRACT

Obstructive sleep apnea is a nocturnal breathing disturbance defined by repeated episodes of upper airway narrowing or occlusion that arise during sleep. Since obstructive sleep apnea can lead to serious comorbidities, early diagnosis and appropriate management are of critical importance. Polysomnography (PSG) continues to serve as the reference benchmark for establishing a definitive diagnosis of obstructive sleep apnea. The evaluation of PSG data is recommended to be performed using the manual scoring guidelines of the American Academy of Sleep Medicine (AASM), version 3, published in 2023. Parameters that must be included in a standard PSG report are general parameters which include epidemiological data with particular attention to age, gender, and body mass index, sleep scoring data, arousal events, cardiac events, movement events, respiratory events and the summary statements. First, sleep stages are determined in 30-second epochs. Total sleep time and sleep efficiency must also be determined. Since obstructive sleep apnea is the most frequently encountered sleep disorder, scoring the respiratory events carefully and determining the apnea-hypopnea index is important. Respiratory events are most frequently scored in 2-minute epochs. Apnea-hypopnea values below 5 are regarded within the normal range, those between 5 and 15 correspond to mild obstructive sleep apnea, scores from 15 to 30 indicate moderate disease, and values exceeding 30 are categorized as severe obstructive sleep apnea. All polysomnographic data must be scored manually by a physician trained and has experience in sleep disorders and PSG. A general review of the sleep study report provides a summary of the recorded data during approximately 6 to 8 hours of monitored sleep. Polysomnographic assessments typically yield two types of reports: the raw PSG report, which contains the procedural data and findings, and the final clinical report (epicrisis), which integrates diagnostic conclusions along with follow-up and treatment recommendations. It is essential for the referring physician to thoroughly review the report and correlate the findings with the patient’s presenting complaints. Based on the observations documented in the sleep study report, multiple clinical recommendations may be made. Accurate interpretation of PSG reports is essential for guiding patient follow-up and clinical decision-making. This chapter aims to inform the reader on PSG reports, whose interpretation is integral to establishing the diagnosis and treatment decisions in obstructive sleep apnea as well as other sleep disorders.

Keywords: Polysomnography; Obstructive sleep apnea; Sleep stages; Sleep; REM

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