Patient name: Troy Hill

DOB: September 12, 1978

Study date: February 15, 2022
Sleep technician: James Williams, RPSGT
Scoring technician: James Williams, RPSGT
SPLIT NIGHT POLYSOMNOGRAPHY WITH CPAP TITRATION:
Overnight polysomnography was performed on this patient was suspected sleep disordered
breathing. The patient is 43 year old African-American male with a BMI of 37. His medications
include labetalol and triamterene/hydrochlorothiazide.
In the beginning of the patient’s waking supine oxyhemoglobin saturation level on room air
began at 95%. Thereafter the patient was awake for 15 minutes prior to sleep onset and then
achieved a slightly decreased sleep efficiency of 79%. Sleep architecture shows elevated stage of
1 and 2 of sleep, absent slow wave sleep and normal REM sleep. Latency to REM sleep was also
normal.
In the initial diagnostic portion of study the patient displayed significant and recurrent
obstructive apneas and hypopneas to yield a high index of 44 events per hour. Central events
were not noted. These events associated with oxyhemoglobin desaturations to a low of 82%.
Snoring was moderate in intensity. Sleep fragmentation was mild.
In the therapeutic portion of study the patient was started on CPAP at 5 CWP using a large full
face mask. Review of polysomnography data shows that he was titrated to final pressure of 15
using the same mask. On this final pressure there appears to be near adequate control.
Apnea/hypopnea index for the therapeutic portion was 28 events per hour. Overall sleep
fragmentation was relatively mild. Periodic limb movements were relatively mild. Rhythm was
normal sinus. His morning questionnaires stated that he slept better than usual.
DIAGNOSIS:
Severe obstructive sleep apnea/hypopnea with index of 44 events per hour and SPO2 Nadir of
82% prior to sleep CPAP initiation. Near adequate control with CPAP at 15 CWP using a large
full face mask.
COMMENTS:
It is recommended that the patient be started on auto CPAP with a pressure range of 10-20 CWP
using a full face mask. He should be followed up clinical efficacy, comfort and compliance.
Weight reduction positional therapy and attention to any sleep hygiene issues were also
recommended. The patient slept in the supine as well as left decubitus position and he appeared
to have more events in the supine position.
Thank you for your kind referral.