Pulmonology Book

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PolysomnogramAka: Sleep Study, UARS, RERA, AHI, RDI, Obstructive Apnea, Obstructive Hypopnea, Upper airway resistance syndrome, Respiratory Effort Related Arousal, Apnea and Hypopnea Index, Respiratory Disturbance Index

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  1. Indications
    1. Sleep Apnea
      1. Central Sleep Apnea
      2. Obstructive Sleep Apnea
  2. Definitions
    1. Obstructive Apnea
      1. Air flow decreases 70% for at least 10 seconds with persistent respiratory effort
    2. Obstructive Hypopnea
      1. Air flow decreases 30% for at least 10 seconds with oxygen desaturation >3%
    3. Upper airway resistance syndrome (UARS)
      1. Variant of Obstructive Sleep Apnea
      2. Less airway collapse and less oxygen desaturation
      3. Frequent arousals occur as with OSA/H
    4. Respiratory Effort Related Arousal (RERA)
      1. Abnormal respiratory event associated with an arousal (e.g. gasping) per hour
    5. Apnea and Hypopnea Index (AHI)
      1. Number of Obstructive Apnea and Obstructive Hypopnea events per hour
    6. Respiratory Disturbance Index (RDI)
      1. Apnea and Hypopnea Index (AHI) and Respiratory Effort Related Arousal (RERA)
  3. Grading
    1. Respiratory Disturbance Index (RDI) <5
      1. No Obstructive Sleep Apnea
      2. No treatment necessary except:
        1. Disruptive snoring
        2. Serious comorbidity (e.g. CHF)
        3. Upper airway resistance syndrome
          1. Consider if significant Sleepiness and Fatigue
    2. Respiratory Disturbance Index (RDI) 5 to 15
      1. Mild Obstructive Sleep Apnea
      2. Consider Upper airway resistance syndrome
    3. Respiratory Disturbance Index (RDI) 16 to 30
      1. Moderate Obstructive Sleep Apnea
    4. Respiratory Disturbance Index (RDI) >30
      1. Severe Obstructive Sleep Apnea

Polysomnography (C0162701)

Definition (MSH)Simultaneous and continuous monitoring of relevant normal and abnormal physiological activity during sleep. (Stedman, 25th ed)
Definition (CSP)simultaneous and continuous monitoring of relevant normal and abnormal physiological activity during sleep.
ConceptsDiagnostic Procedure (T060)
ICD989.17, 89.17
MSHD017286
EnglishFull sleep study, POLYSOMNOGR, Polysomnogram, Polysomnographies, Polysomnography, PSG, sleep measurement, Sleep Monitoring, Sleep recording, Sleep studies, Sleep Testing, SOMNOGR, Somnographies, Somnography
Spanishestudios del sueno, polisomnografia, polisomnograma
Parent ConceptsMeasurement (C0242485), Anatomic and physiologic measurements and manual examinations -- nervous system and sense organs (C0177813), Monitoring, Physiologic (C0026429), diagnostic procedure (C0430022), Sleep-related breathing test (C0430628), Procedure by device (C1285536)
SourcesCSP, ICD9CM, LNC, MSH, MTH, MTHCH, MTHICD9, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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