Home Sleep Apnea Monitoring

James D. Geyer, MD

Paul R. Carney, MD

FIGURE 12-1 HSAT: Standard montage; 30 second page.

Clinical: 36-year-old overweight man with daytime sleepiness.

Respiratory: Normal respirations with no snoring.

FIGURE 12-2 HSAT: Standard montage; 60 second page.

Clinical: 36-year-old overweight man with daytime sleepiness.

Respiratory: Normal respirations with no snoring.

FIGURE 12-3 HSAT: Standard montage; 120 second page.

Clinical: 36-year-old overweight man with daytime sleepiness.

Respiratory: Normal respirations with no snoring.

FIGURE 12-4 HSAT: Standard montage; 30 second page.

Clinical: 47-year-old woman with fatigue and snoring.

Respiratory: Normal respirations with snoring.

FIGURE 12-5 HSAT: Standard montage; 60 second page.

Clinical: 47-year-old woman with fatigue and snoring.

Respiratory: Normal respirations with snoring.

FIGURE 12-6 HSAT: Standard montage; 30 second page.

Clinical: 46-year-old obese man with suspected obstructive sleep apnea.

Respiratory: Hypopnea.

FIGURE 12-7 HSAT: Standard montage; 60 second page.

Clinical: 46-year-old obese man with suspected obstructive sleep apnea.

Respiratory: Hypopnea.

FIGURE 12-8 HSAT: Standard montage; 30 second page.

Clinical: 52-year-old man with snoring, sleepiness, and a history of facial trauma.

Respiratory: Obstructive apnea.

FIGURE 12-9 HSAT: Standard montage; 120 second page.

Clinical: 41-year-old obese man with suspected obstructive sleep apnea.

Respiratory: Obstructive apnea.

FIGURE 12-10 HSAT: Standard montage; 5 minute page.

Clinical: 41-year-old obese man with suspected obstructive sleep apnea.

Respiratory: Obstructive apnea.

FIGURE 12-11 HSAT: Standard montage; 60 second page.

Clinical: 53-year-old obese man with reported sleep apnea.

Respiratory: Central apnea.

FIGURE 12-12 HSAT: Standard montage; 60 second page.

Clinical: 53-year-old obese man with reported sleep apnea.

Respiratory: Central apnea.

FIGURE 12-13 HSAT: Standard montage; 5 minute page.

Clinical: 53-year-old obese man with reported sleep apnea.

Respiratory: Central apnea.

FIGURE 12-14 HSAT: Standard montage; 30 second page.

Clinical: 61-year-old man with heart failure and witnessed apnea.

Respiratory: Central apnea/Cheyne-Stokes respirations.

TABLE 12-1 HSAT Normal Report

Study Description: Sleep Study, Unattended (95806)						Study Date: 12/3/2016
Patient name:				Recording device:		No. 1002
Sex:		Female		Height:		69 inch
D.O.B.:		11/24/1992		Weight:		210 pounds
Age:		24 years		BMI:		31.01
Referring Physician:
Indications: Apnea, unspecified (G47.30). Snoring (R06.83).
Times and Durations
Lights off clock time:		12:36:03 AM		Total recording time (TRT):		381.6 minutes
Lights on clock time:		6:57:39 AM		Time in bed (TIB):		381.6 minutes
				Monitoring time (MT):		375.6 minutes
Device and Sensor Details
The study was recorded on an approved type III device using 1 RIP effort belt and a pressure-based flow sensor. The heart rate is derived from the oximeter sensor, and the snore signal is derived from the pressure sensor. The device also records body position and uses it to determine the monitoring time (sleep/wake periods).
Summary: REI is the number of respiratory events per hour. OAI is the number of obstructive apneas per hour. CAI is the number of central apneas per hour. Lowest desaturation is the lowest blood oxygen level that lasted at least 2 seconds.
REI	3.4	OAI	0.3	CAI	0.3	Lowest desaturation			92
Please note that the “REI” in the report is consistent with the alternative hypopnea definition according to AASM criteria where there is a greater than or equal to a 3% oxygen desaturation from pre-event baseline.
RESPIRATORY EVENTS
		Index (no. per hour)	Total No. of Events	Mean Duration (seconds)	Maximum Duration (seconds)	No. of Events by Position
						Supine	Prone	Left	Right	Up
Central apneas		0.3	2	11.5	12.5	1	0	1	0	0
Obstructive apneas		0.3	2	38.0	66.0	1	0	0	0	1
Mixed apneas		0.0	0	0.0	0.0	0	0	0	0	0
Hypopneas		2.7	17	27.4	52.0	15	0	1	1	0
Apneas + hypopneas		3.4	21	26.9	66.0	17	0	2	1	1
RERAs		0.0	0	0.0	0.0	0	0	0	0	0
Total		3.4	21	26.9	66.0	17	0	2	1	1
Time in position						264.3	0.1	96.2	12.3	4.8
REI in position						3.9	0.0	1.2	4.9	27.3

Oximetry Summary

	Duration (minutes)	% TIB
<90%	0.0	0.0
<85%	0.0	0.0
<80%	0.0	0.0
<70%	0.0	0.0
Total duration (minutes) < 0		minutes
Average (%)		97
Total no. of desaturations		9
Desaturation index (no. per hour)		1.4
Desaturation maximum (%)		6
Desaturation maximum duration (seconds)		45.5
Lowest SpO₂ % during sleep		92
Duration of minutes SpO₂ (seconds)		5
Highest SpO₂ % during sleep		99
Duration of maximum SpO₂ (seconds)		26

Heart Rate Stats

Mean HR during sleep	62.7 (bpm)
Highest HR during sleep	108 (bpm)
Highest HR during TIB	108 (bpm)
Lowest HR during sleep	51 (bpm)
Lowest HR during TIB	51 (bpm)

Snoring Summary

Mild

HST: This home monitoring sleep test did not reveal any definite evidence of a sleep-related breathing disorder. A negative home sleep study does not completely exclude the possibility of a sleep-related breathing disorder such as obstructive sleep apnea. Clinical correlation is advised.

Recommendations: The patient will follow up with her cardiologist.

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