Polysomnography Interpretation Report (Split-Night PSG)

Patient: [Full name] | [MRN] | [DOB] | [Sex]

Study Date: [Start date and clock time] to [End date and clock time]

Facility: [Sleep lab name]

Ordering Clinician: [Name, credentials]

Interpreting Physician: [Name, credentials]

Study Type: Attended in-lab PSG; split-night protocol (diagnostic → PAP titration)

Clinical Indication

[Reason for study and clinical question] (Summarize referral reason and key symptoms such as snoring, witnessed apneas, nocturnal choking/gasping, non-restorative sleep, morning headaches, daytime sleepiness, or drowsy driving. Include Epworth Sleepiness Scale if available.)

[Pertinent medical and sleep history] (Include relevant cardiopulmonary disease, neuromuscular conditions, heart failure, chronic opioid use, and prior sleep diagnoses. If history is limited, explicitly state this.)

[Medications/substances taken day of study affecting sleep or respiration]

[Anthropometrics: height, weight, BMI]

[Prior sleep testing and PAP exposure history] (Include prior HST/PSG results and PAP usage or intolerance if known.)

Methods

Type 1 attended in-lab polysomnography with synchronized video and audio monitoring. Channels recorded: [EEG montage], [EOG], [chin EMG], [ECG], [airflow: nasal pressure transducer ± thermistor], [respiratory effort: thoracic and abdominal belts], [pulse oximetry], [snore microphone], [body position], [bilateral anterior tibialis EMG], [transcutaneous/end-tidal CO₂] (Include CO₂ only if monitored).

Sleep staging and respiratory event scoring per AASM Scoring Manual [version/year]. Hypopnea definition: [3% desaturation and/or arousal / 4% desaturation-only]. RERAs [were / were not] scored. Primary reporting index: [AHI / RDI].

Split-night protocol: initial diagnostic recording followed by PAP titration upon meeting predefined criteria. Titration utilized [PAP mode(s): CPAP / BPAP-S / BPAP-ST / ASV], interface [mask type and size], [heated humidification: on/off], and [supplemental oxygen at [flow rate] L/min] (Include oxygen only if used).

Study Quality and Limitations

[Signal quality summary] (Note any lead failures, artifact, or data loss affecting staging or respiratory scoring.)

[Representativeness] (State whether supine sleep and REM sleep were achieved in both diagnostic and titration segments.)

[Adequacy of diagnostic and titration durations]

(If limitations materially affect conclusions or prescription confidence, explicitly describe how.)

Sleep Architecture

Diagnostic Portion

Parameter	Value
Total Sleep Time (TST)	[minutes]
Sleep Efficiency	[%]
Sleep Latency	[minutes]
REM Latency	[minutes]
Wake After Sleep Onset (WASO)	[minutes]
Stage N1	[% of TST]
Stage N2	[% of TST]
Stage N3	[% of TST]
REM	[% of TST]
Arousal Index	[events/hour]

(If staging is unreliable due to artifact, state explicitly and omit uncertain percentages.)

Titration Portion

Parameter	Value
Total Sleep Time (TST)	[minutes]
Sleep Efficiency	[%]
Sleep Latency	[minutes]
REM Latency	[minutes]
Wake After Sleep Onset (WASO)	[minutes]
Stage N1	[% of TST]
Stage N2	[% of TST]
Stage N3	[% of TST]
REM	[% of TST]
Arousal Index	[events/hour]

(If staging is unreliable due to artifact, state explicitly and omit uncertain percentages.)

Respiratory and Oxygenation Findings — Diagnostic Portion

Hypopnea rule: [3% desaturation and/or arousal / 4% desaturation-only]. Reporting index: [AHI / RDI].

Metric	Value
[AHI / RDI]	[events/hour]
Obstructive Apnea Index	[events/hour]
Central Apnea Index	[events/hour]
Mixed Apnea Index	[events/hour]
Hypopnea Index	[events/hour]
RERA Index	[events/hour]
Supine [AHI / RDI]	[events/hour]
Non-supine [AHI / RDI]	[events/hour]
REM [AHI / RDI]	[events/hour]
NREM [AHI / RDI]	[events/hour]
Baseline SpO₂	[%]
Mean SpO₂	[%]
Nadir SpO₂	[%]
Time SpO₂ < 90%	[minutes] ([% of TST])
Time SpO₂ < 88%	[minutes] ([% of TST])
ODI ([3% / 4%] desaturation)	[events/hour]

(Include positional and stage-specific indices only if sufficient time was recorded in each condition. Omit RERA row if not scored.)

[Interpretive summary] (Provide severity classification: [none / mild / moderate / severe]. Note phenotype: [positional / REM-predominant / non-positional]. Comment on central events, hypoventilation, or other notable respiratory patterns.)

Split-Night Conversion

• Diagnostic recording time prior to conversion: [clock time range] ([total minutes])
• Diagnostic sleep time prior to conversion: [minutes]
• Qualifying [AHI / RDI] triggering conversion: [events/hour] with [associated severity features if present]
• PAP initiation time: [clock time]
• Remaining titration time: [minutes]
• Split-night criteria: [met / partially met] (If partially met, describe limitations.)

PAP Titration Results

Mode	Pressure	Time	Stages	Position	Residual [AHI / RDI]	SpO₂	Leak	Comments
[CPAP / BPAP-S / BPAP-ST / ASV]	[cm H₂O or IPAP/EPAP]	[minutes]	[REM / NREM]	[Supine / Non-supine]	[events/hour]	[Mean / nadir]	[Acceptable / Excessive]	[Intolerance, central emergence, oxygen added, etc.]
(Add rows for each pressure/mode change)

Selected effective pressure: [Mode] at [pressure setting] — residual [AHI / RDI] [events/hour], oxygenation [adequate / requiring supplemental O₂], supine REM [achieved / not achieved], leak [acceptable / excessive].

Titration quality grade: [optimal / good / adequate / inadequate] — [brief justification based on stage/position sampling, stability, leak, and tolerance].

(If supine REM was not achieved at final pressure, state that recommendation is provisional pending clinical response and device data. Document treatment-emergent central apneas, persistent hypoxemia, or interface intolerance if present.)

Other Findings

• Periodic limb movements: PLM Index [events/hour]; PLM arousal index [events/hour]. [Clinical relevance if elevated]
• Cardiac: Mean sleeping HR [bpm]; rhythm [sinus / other]; [notable arrhythmias or "no significant arrhythmias"]
• Behavioral/neurologic: [Significant events on video review or "no abnormal behaviors observed"]
• Position distribution: Diagnostic [supine %] / [non-supine %]; Final titration pressure [supine %] / [non-supine %]

Impression

• [Primary diagnosis]: [Obstructive sleep apnea / Central sleep apnea / Mixed], [severity] based on [AHI / RDI] of [value] using [hypopnea rule]; [positional / REM-predominant / non-positional] phenotype
• [Secondary diagnoses]: [Treatment-emergent central apnea / sleep-related hypoxemia / periodic limb movement disorder] (Include only if supported by data)
• Titration conclusion: Effective pressure [identified / not identified]; confidence [high / moderate / low] based on [REM/supine sampling and titration quality grade]
• Key limitations: [Limitations affecting interpretation or prescription confidence]

Recommendations

PAP Prescription:

• Device/mode: [CPAP / Auto-CPAP / BPAP-S / BPAP-ST / ASV]
• Pressure: [Fixed pressure or range in cm H₂O; IPAP/EPAP if BPAP]
• Pressure relief: [EPR / C-Flex / A-Flex: on/off and level]
• Humidification: [Heated humidifier on/off]
• Interface: [Mask type and size]; chin strap [yes / no]
• Supplemental oxygen: [Flow rate] L/min (Include only if indicated)

Clinical Follow-up:

• Device data review and clinical follow-up in [timeframe, e.g., 4–6 weeks]
• [Repeat full-night titration recommended] (Include if split-night titration was inadequate or limited)
• [Adjunctive measures: positional therapy, weight management, alcohol/sedative avoidance] (Include as applicable)
• [Drowsy driving counseling] (Include if excessive sleepiness documented)

Signature

Interpreting Physician: [Name, credentials] — [Electronic signature / date / time]