> For clean Markdown of any page, append .md to the page URL. > For a complete documentation index, see https://docs.emtelligent.com/llms.txt. > For AI client integration (Claude Code, Cursor, etc.), connect to the MCP server at https://docs.emtelligent.com/_mcp/server. # Sleep Apnea Experienced by Patients ## Synopsis This query searches for mentions of sleep apnea in patient records using multi-concept search and returns only those experienced by the patient. This query demonstrates how to use experiencer relations to exclude those entities that were experienced by persons other than the patient themselves (such family members). ## Processing Requirements This query assumes that at least the following `emtellipro-db-client` processing options were enabled: * `--feature experiencer-relation, snomed-ontology` * `--store-sections-and-sentences` For this query, Clinical notes were processed with the following document type: * `--category Clinical` * `--subcategory generic` (or more specific report types such as Discharge Summary, SOAP Note, CCD as applicable) ## Clinical Context This query is similar to the [multi-concept query on sleep apnea](/nlp/database/cookbook/concept-queries/multi-concept/sleep-apnea) except that it uses a CTE to identify cases where the experiencer of the sleep apnea concept is either implicitly or explicitly labeled as being the patient, rather than a family member or other person. This query can have the experiencer concepts in it modified to find mentions of the concepts of clinical concern that apply to other persons, for example a `72705000 |Mother (person)|` or `65616008 |Son (person)|`. Multi-concept query for: * `78275009 |Obstructive sleep apnea syndrome (disorder)|` * `73430006 |Sleep apnea (disorder)|` * `55442000 |Paroxysmal nocturnal dyspnea (finding)|` * `62744007 |Orthopnea (finding)|` * `47545007 |Continuous positive airway pressure ventilation treatment (regime/therapy)|` ## SQL query #### SQL ```sql -- Combining concept search with experiencer relation WITH explicitpatients_ers AS (SELECT er.id AS expid FROM experiencerrelation er JOIN entity e ON er.experiencer_id = e.id -- NOTE: find experience(r) entities JOIN foundentity fe ON fe.id = e.entity_id -- IMPORTANT: e.entity_id not e.id JOIN foundentityconcept fec ON fe.id = fec.found_entity_id JOIN concept c ON c.concept_id = fec.concept_id AND c.ontology = fec.concept_ontology WHERE c.ontology = 'snomed' AND e.type_ = 'found' -- IMPORTANT: this condition is required. AND c.concept_id = '116154003'), -- SNOMED CT concept id for patient implicitpatients_ers AS (SELECT er.id AS expid FROM entity e JOIN experiencerrelation er ON er.experiencer_id = e.id -- NOTE: experience(r) entities JOIN assumedentity ae ON ae.id = e.entity_id WHERE e.type_ = 'assumed' AND ae.value = 'patient'), patient_ers AS ( -- experiencer relations where subject is patient SELECT expid FROM implicitpatients_ers UNION SELECT expid FROM explicitpatients_ers ) SELECT c.concept_id As concept_id, c.description AS concept_description, fe.section_name, fe.text AS annotated_text, sl.text AS sentence FROM patient_ers JOIN experiencerrelation er ON patient_ers.expid = er.id JOIN entity e ON er.experienced_id = e.id -- NOTE: experience(d) entities JOIN foundentity fe ON fe.id = e.entity_id AND e.type_ = 'found' JOIN foundentityconcept fec ON fe.id = fec.found_entity_id JOIN concept c ON c.concept_id = fec.concept_id AND c.ontology = fec.concept_ontology JOIN foundentitylocation fel ON fe.id = fel.found_entity_id JOIN location l ON fel.location_id = l.id AND l.type_ = 'sentence' -- IMPORTANT: check that location type is 'sentence' JOIN sentencelocation sl ON sl.id = l.location_id WHERE c.ontology = 'snomed' AND er.polarity = 'asserted' AND c.concept_id IN ('78275009', '73430006', '55442000', '62744007', '47545007') AND fe.polarity = 'asserted' AND fe.uncertainty = 'certain'; ``` #### Snowflake ```sql -- Combining concept search with experiencer relation WITH distinct_concepts AS (SELECT DISTINCT * FROM concept ), explicitpatients_ers AS (SELECT er.id AS expid FROM experiencerrelation er JOIN entity e ON er.experiencer_id = e.id -- NOTE: find experience(r) entities JOIN foundentity fe ON fe.id = e.entity_id -- IMPORTANT: e.entity_id not e.id JOIN foundentityconcept fec ON fe.id = fec.found_entity_id JOIN distinct_concepts c ON c.concept_id = fec.concept_id AND c.ontology = fec.concept_ontology WHERE c.ontology = 'snomed' AND e.type_ = 'found' -- IMPORTANT: this condition is required. AND c.concept_id = '116154003'), -- SNOMED CT concept id for patient implicitpatients_ers AS (SELECT er.id AS expid FROM entity e JOIN experiencerrelation er ON er.experiencer_id = e.id -- NOTE: experience(r) entities JOIN assumedentity ae ON ae.id = e.entity_id WHERE e.type_ = 'assumed' AND ae.value = 'patient'), patient_ers AS ( -- experiencer relations where subject is patient SELECT expid FROM implicitpatients_ers UNION SELECT expid FROM explicitpatients_ers ) SELECT c.concept_id As concept_id, c.description AS concept_description, fe.section_name, fe.text AS annotated_text, sl.text AS sentence FROM patient_ers JOIN experiencerrelation er ON patient_ers.expid = er.id JOIN entity e ON er.experienced_id = e.id -- NOTE: experience(d) entities JOIN foundentity fe ON fe.id = e.entity_id AND e.type_ = 'found' JOIN foundentityconcept fec ON fe.id = fec.found_entity_id JOIN distinct_concepts c ON c.concept_id = fec.concept_id AND c.ontology = fec.concept_ontology JOIN foundentitylocation fel ON fe.id = fel.found_entity_id JOIN location l ON fel.location_id = l.id AND l.type_ = 'sentence' -- IMPORTANT: check that location type is 'sentence' JOIN sentencelocation sl ON sl.id = l.location_id WHERE c.ontology = 'snomed' AND er.polarity = 'asserted' AND c.concept_id IN ('78275009', '73430006', '55442000', '62744007', '47545007') AND fe.polarity = 'asserted' AND fe.uncertainty = 'certain'; ``` | concept_id | concept_description | section_name | annotated_text | sentence | | ---------- | -------------------------------------------------------------------------- | -------------------- | -------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ | | 47545007 | Continuous positive airway pressure ventilation treatment (regime/therapy) | SUBJECTIVE | CPAP | Mr. Sidney is a 50-year-old man who returns to discuss his still moderate-to- sleep apnea, and to review his response to CPAP. | | 47545007 | Continuous positive airway pressure ventilation treatment (regime/therapy) | ASSESSMENT | CPAP | I recommend he continues CPAP indefinitely. | | 47545007 | Continuous positive airway pressure ventilation treatment (regime/therapy) | SUBJECTIVE | CPAP | He estimates that he uses the CPAP approximately 4-6 nights per week, and on occasion takes it off and does not replace the mask when he awakens spontaneously in the middle of the night. | | 47545007 | Continuous positive airway pressure ventilation treatment (regime/therapy) | SUBJECTIVE | CPAP | As noted, the patient is not snoring on CPAP. | | 47545007 | Continuous positive airway pressure ventilation treatment (regime/therapy) | SUBJECTIVE | CPAP | He was found to have moderate-to-severe sleep apnea, and was treated with nasal CPAP for the past few months. | | 47545007 | Continuous positive airway pressure ventilation treatment (regime/therapy) | ASSESSMENT | CPAP | If this continues, we can consider a new sleep study to determine whether he still needs CPAP. | | 73430006 | Sleep apnea (disorder) | ASSESSMENT | sleep apnea | Moderate-to-severe sleep apnea. | | 73430006 | Sleep apnea (disorder) | SUBJECTIVE | sleep apnea | He was found to have moderate-to-severe sleep apnea, and was treated with nasal CPAP for the past few months. | | 78275009 | Obstructive sleep apnea syndrome (disorder) | PAST MEDICAL HISTORY | OSA | OSA | | 78275009 | Obstructive sleep apnea syndrome (disorder) | DISCHARGE DIAGNOSIS | OSA | OSA | ## Related links * [Experiencer Relations](/nlp/database/schema/relations/experiencer) * [Entity-level Tables](/nlp/database/schema/core/entity-tables)