@php $data = $sleepHistory['data']; $patient = $data['patientInformation'] ?? []; $medical = $data['medicalHistory'] ?? []; $schedule = $data['sleepSchedule'] ?? []; $daytime = $data['daytimeSleepiness'] ?? []; $night = $data['nightSymptomsBehaviors'] ?? []; $summary = $data['sleepProblemsSummary'] ?? []; $gender = strtolower($patient['gender'] ?? ''); $he = $gender == 'female' ? 'She' : 'He'; $his = $gender == 'female' ? 'Her' : 'His'; $height = isset($patient['height']) ? (float)$patient['height'] : null; $weight = isset($patient['weight']) ? (float)$patient['weight'] : null; $bmi = ($height && $weight) ? round($weight / (($height/100)*($height/100)), 1) : ''; $epworth = array_sum($daytime['epworth'] ?? []); if($epworth <= 8) $severity = "normal"; elseif($epworth <= 12) $severity = "mild"; elseif($epworth <= 16) $severity = "moderate"; else $severity = "severe"; @endphp
Sukarno N. Chaudhry, FRCPC, ABIM
Practising in Sleep Medicine
Board Certified in Sleep Medicine
and Respiratory Medicine
Medical Director and Quality Advisor 		OSHAWA-DURHAM SLEEP LABORATORY INC.

Varinderjit S. Parmar, FRCPC, ABPN, DRCPSC (Sleep Medicine)
Practising in Sleep Medicine
Board Certified in Psychiatry
Associate Physician 		Malcolm Blagrove, MD
FRCPC, DRCPSC Practising in Sleep Medicine
RCPSC Specialist in Respiratory and Internal Medicine
Associate Physician

292 King St. W. Oshawa, ON L1J 2J9
Tel. (905) 436-6163    Fax (905) 432-7099

Re: {{ $patient['name'] ?? '' }}
DOB: {{ $patient['dob'] ?? '' }}
Our Chart No.: {{ $patient['chartNo'] ?? '' }}
Height: {{ $height }} cm
Weight: {{ $weight }} kg
BMI: {{ $bmi }}
Current occupation: {{ $patient['occupation'] ?? '' }}

Thank you for referring {{ $patient['name'] ?? 'the patient' }} for assessment of sleep related medical problems. {{ $he }} indicated {{ strtolower($he) }} has been experiencing sleep problems for approximately {{ $summary['problemsDurationValue'] ?? '?' }} {{ $summary['problemsDurationUnit'] ?? '' }}.

Current occupation: {{ $patient['occupation'] ?? '' }}
Unable to work because of health - {{ $schedule['unableToWorkHealth'] ?? 'No' }}
Retired - {{ $schedule['retired'] ?? 'No' }}
Shift worker - {{ $schedule['shiftWork'] ?? 'No' }}

DAYTIME SLEEPINESS: {{ $he }} indicates {{ strtolower($he) }} at times gets urges to fall asleep during the day. On the Epworth Sleepiness Scale, {{ strtolower($he) }} gives a self-rating of {{ $epworth }} indicating {{ $severity }} sleepiness.

SLEEP HISTORY: @if(($night['sleepAlone'] ?? '') == 'Yes') {{ $he }} sleeps alone. @else {{ $he }} sleeps with a partner. @endif {{ $he }} indicates that {{ strtolower($he) }} has experienced:

@foreach([ 'snore' => 'Snoring', 'dryMouthMorning' => 'Dry mouth upon awakening', 'headaches' => 'Headaches after usual sleep time or during sleep', 'restlessSleeper' => 'Restless sleep', 'kickDuringSleep' => 'Kicking during sleep', 'jerkDuringSleep' => 'Body jerking during sleep', 'teethGrinding' => 'Teeth grinding' ] as $key => $label) @if(($night[$key] ?? '') == 'Yes') {{ $label }}
@endif @endforeach
FAMILY SLEEP HISTORY
@php $familySleep = $night['violentDuringSleepArray']['familyHistorySleepDisordersArray'] ?? []; @endphp @if(empty(array_filter($familySleep))) {{ $he }} is unaware of any family history of sleep disorders. @else Family history includes: @foreach($familySleep as $k => $v) @if($v) {{ $k }}, @endif @endforeach @endif

PAST MEDICAL HISTORY:
Drug allergies - {{ $medical['drugAllergies'] ?? 'None' }}
Smokes marijuana or takes psychotropic drugs - {{ $medical['marijuanaPsychotropic'] ?? 'No' }}
Consumes alcohol - {{ $medical['consumeAlcohol'] ?? 'No' }}
@if(($medical['consumeAlcohol'] ?? '') == 'Yes') Number of alcoholic drinks per day – {{ $medical['consumeAlcoholArray']['alcoholDrinksPerDay'] ?? '' }}
Number of days per week – {{ $medical['consumeAlcoholArray']['alcoholDaysPerWeek'] ?? '' }}
@endif Number of caffeinated drinks per day – {{ (int)($medical['caffeineCoffee'] ?? 0) + (int)($medical['caffeineTea'] ?? 0) + (int)($medical['caffeineColas'] ?? 0) }}
Smoker - {{ $medical['smoke'] ?? 'No' }}

FAMILY MEDICAL HISTORY
@php $familyMed = array_filter($medical['familyHealthHistory'] ?? []); @endphp @if(count($familyMed)) Family history of: @foreach($familyMed as $k => $v) {{ $k }}, @endforeach @else No significant family medical history reported. @endif

MEDICATIONS
@foreach(($medical['medications'] ?? []) as $med) {{ $med['name'] ?? '' }}
@endforeach

In summary, clinical assessment indicated significant sleep/wake symptoms and that polysomnography may be necessary to complete an evaluation. A sleep study may be arranged and a final report will be provided upon completion of investigation. Thank you for allowing us to participate in care.