NARRATIVE POLYSOMNOGRAPHY REPORT

Name Hiraben Maheshbhai Rupani,

Age/Sex 49 / F Referred By :- Dr Vimal Dhaduk

STUDY PERFORMED : Whole Night Diagnostic Polysomnography.

PROCEDURE : PSG was conducted on the night of 27-04-2025. The following were monitored:
central EEG, electrooculogram (EOG), submentalis EMG, nasal and oral airflow, thoracic and
abdominal wall motion, anterior tibialis EMG, body position and electrocardiogram. Arterial oxygen
saturation was monitored with a pulse oximeter. The tracing was scored using 30 second epochs.
Hypopneas were scored per AASM definition.

SUMMARY : Total recording time was 362.0 min, with a total sleep time of 361.5 min
and a sleep efficiency of 99.9 %. The patient’s sleep latency was 0.5 min. There was a total of 13.3% REM
Sleep with the REM latency of 11.5 min. There was 21.7% of Stage 1 sleep, 37.1% Stage 2, 27.9% % Stage 3 .

Respiratory Analysis demonstrated 71 obstructive, 25 central & 2 mixed apneas with an Apnea index of
16.3. There were 180 hypopneas, with an Apnea-Hypopnea Index AHI: 46.1. Patient spent 339.8 min of
TST in the supine position, with a supine AHI of 47.3. REM AHI was 16.3, verses Non-REM AHI: 50.7.
The lowest desaturation was 85 % with 3.3 mins of study spent at oxygen saturations < 90%. Sleep was
fragmented with the total arousal index of 19.1. Respiratory arousal index was 4.1. Total 0 events of
Bradycardia observed.

DIAGNOSIS :
1) Severe Obstructive Sleep Apnea.Syndrome.
2) Shallow and fragmented sleep . Abnormal Sleep Architecture.Less REM Sleep
3) Severe nocturnal hypoxemia was observed.

Dr. Vimal Dhaduk

M.S.(Gastr-Bariatric Surgeon)

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 Patient Information

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 Name Hiraben Maheshbhai Rupani, Age 49
Mr 667 Ht-ft 5’2” Referred By Dr Vimal Dhaduk
Sex F Wt-kg 103kgs
Study 667 BMI 41.5
Indication Morbid Obesity , Snoring , Nocturia , Gastric Issues , Daytime Sleepiness.
Polysomnography was conducted on the night of 27-04-2025. The following were monitored: central and occipital EEG,
electrooculogram (EOG), submentalis EMG, nasal and oral airflow, thoracic and abdominal wall motion, anterior tibialis EMG,
body position and electrocardiogram. Arterial oxygen saturation was monitored with a pulse oximeter. The tracing was scored
using 30 second epochs. Hypopneas were scored per AASM definition
Sleep Summary
Lights Out: 00:58:02 Stage Duration % TST
Lights On: 07:00:02 N1 78.5 min 21.7%
Total Recording Time: 362.0 min N2 134.0 min 37.1%
Total Sleep Time (TST): 361.5 min N3 101.0 min 27.9%
Sleep Period Time: 361.5 min R 48.0 min 13.3%
Sleep Onset: 00:58:32
Sleep Efficiency: 99.9 % Latencies From Lights Out From Sleep Onset
Sleep Latency (from LOff): 0.5 min N1 0.5 min 0.0 min
R Latency (from Sleep Onset): 11.5 min N2 1.0 min 0.5 min
Wake After Sleep Onset (WASO): 0.0 min N3 1.5 min 1.0 min
Wake During Sleep: 0.0 min R 12.0 11.5
Total Wake Time: 0.5 min
% Wake Time: 0.1

Respiratory Summary
By Event Classification Central Mixed Obstructive
Count Mean Max Count Mean Max Count Mean Max
Apneas, NREM 25 35.9 110.0 2 12.5 15.0 66 16.1 294.5
Apneas, REM 0 0.0 0.0 0 0.0 0.0 5 10.0 10.0
Apneas, Total 25 35.9 110.0 2 12.5 15.0 71 15.7 294.5
*Hypopneas scored based on 0% or greater desaturation.
Hypopneas, NREM 172 11.0 43.0 RERAs, NREM 0 0.0 0.0
Hypopneas, REM 8 10.0 10.0 RERAs, REM 0 0.0 0.0
Hypopneas, Total 180 11.0 43.0 RERAs, Total 0 0.0 0.0
Event Statistics Total With Arousal
Count Index Count Index
Apneas, Total 98 16.3 14 2.3
Hypopneas, Total 180 29.9 11 1.8
Apnea + Hypopnea Total 278 AHI: 46.1 25 4.1
Apnea + Hypopnea NREM 265 AHI: 50.7 24 4.6
Apnea + Hypopnea REM 13 AHI: 16.3 1 1.3
RERAs, Total 0 0.0 0 0.0
Total Events (A+H+RERA) Total 278 RDI: 46.1 25 4.1
Total Events (A+H+RERA) NREM 265 RDI: 50.7 24 4.6
Total Events (A+H+RERA) REM 13 RDI: 16.3 1 1.3

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Cheyne Stokes Breathing: None Present

Hypoventilation: None Present

Respiratory Summary by Body Position

By Body Position Back Left Right Prone Total Back Left Right Prone Total
Apn Index, REM 6.3 0.0 6.3 AHI, REM 16.3 0.0 16.3
Apn Index, NREM 18.3 0.0 17.8 AHI, NREM 52.4 100.0 50.7
Apn Index, Total 16.6 0.0 16.3 AHI, Total 47.3 100.0 46.1
Hyp Index, REM 10.0 0.0 10.0 RDI, REM 16.3 0.0 16.3
Hyp Index, NREM 34.1 100.0 32.9 RDI, NREM 52.4 100.0 50.7
Hyp Index, Total 30.7 100.0 29.9 RDI, Total 47.3 100.0 46.1
Duration (min) 339.8 0.6 361.5 TST (min) 339.8 0.6 362.0

Heart Rate Summary

Average Heart Rate During Sleep 73.3 bpm
Highest Heart Rate During Sleep 255 bpm
Highest Heart Rate During Sleep 95th % 136.0 bpm
Highest Heart Rate During Recording (TIB) 255 bpm
Highest Heart Rate During Recording (TIB) 95th % 136.0 bpm
Heart Rate Observations
Event Type # Events
Bradycardia 0 Lowest HR Scored: N/A
Sinus Tachycardia During Sleep 0 Highest HR Scored: N/A
Narrow Complex Tachycardia 0 Highest HR Scored: N/A
Wide Complex Tachycardia 0 Highest HR Scored: N/A
Asystole 0 Longest Pause: N/A
Atrial Fibrillation 0 Duration Longest Event: N/A
Other Arrythmias Yes or No Description:

Periodic Leg Movements

Total # Limb Movement 963 Limb Movement Index 159.8
Total # PLMS 534 PLMS Index 88.6
Total # PLMS Arousals 47 PLMS Arousal Index 7.8

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 Arousals
Limb
Total # Respiratory Movement Snore Spontaneous
REM 4 1 2 0 1
NREM 111 24 48 0 39
WAKE 0 0 0 0 0
TOTAL 115 25 50 0 40
INDEX 19.1 4.1 8.3 0.0 6.6

Oximetry Data
Average O2 while awake 95 % Average O2 while in Non-REM 95 %
Average O2 while in REM 95 % Approximate minimum O2 value 85 %
Oximetry Distribution
WK REM NREM Total
<50 % (min) 0.0 0.0 0.0 0.0
<60 % (min) 0.0 0.0 0.0 0.0
<70 % (min) 0.0 0.0 0.0 0.0
<75 % (min) 0.0 0.0 0.0 0.0
<80 % (min) 0.0 0.0 0.0 0.0
<85 % (min) 0.0 0.0 0.0 0.0
<90 % (min) 0.0 0.0 3.3 3.3
<95 % (min) 0.1 15.2 65.5 80.8
<0 % (min)
Fail (min) 0.1 0.2 42.2 42.5
Average (%) 95 95 95 95
Desat Index (#/hour) 8.8 18.6 17.1
Desat Max (%) 0 5 11 11
Desat Max Dur (sec) 0.0 33.0 45.0 45.0
Oximetry Summary
W R NR Total
Fail Duration (min) 0.1 0.2 42.2 42.5
Average (%) 95 95 95 95
# of Desaturations* 0 7 84 91
Desat Index (#/hour) 8.8 18.6 17.1
Desat Max Dur (sec.) 0.0 33.0 45.0 45.0

*Desaturations based on 3% or greater drop from baseline.

Minimum SpO2 value during sleep: 85%
Minimum SpO2 value duration during sleep: 16 seconds
Minimum SpO2 value associated with a respiratory event: 87%

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 NIGHT HYPNOGRAM
W Sta g e

N1
N2

N3
HR,BPM
190
170
150
130
11 0
90
70
50
30
100 Sp O2 ,%
90
80
70
60
50
20 CA,s e c

10
0
20 OA,s e c

10

0
20 MA,s e c

10
0
20 HYPO,s e c

10
0
30 L e g Mv t,s e c

15

0
30 a ro u s a l ,s e c

15

0
L Po s
P
PL
S S S S S S
SL
R
SR
PR
. . . .

0 0 :5 8 :0 2 0 2 :0 0 0 3 :0 0 0 4 :0 0 0 5 :0 0 0 6 :0 0

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