Patient name: Damon Smith

DOB: May 17, 1972

Study date: February 16, 2022
Sleep technician: Daniel Blazek, RPSGT
Scoring technician: Daniel Blazek, RPSGT
SPLIT NIGHT POLYSOMNOGRAPHY WITH CPAP TITRATION:
Overnight polysomnography was performed on this patient was suspected sleep disordered
breathing. The patient is 49 year old male with a BMI of 41. His medications include Zestoretic.
In the beginning of the study the patient’s waking oxyhemoglobin saturation level on room air
and in the right decubitus position began at 96%. Thereafter the patient was awake for 2.5
minutes prior to sleep onset and then achieved a normal sleep efficiency of 87%. Sleep
architecture shows normal stage 1 of sleep, elevated stage 2 of sleep, normal slow wave sleep
and normal REM sleep with normal latency.
In the initial diagnostic portion of the study the patient displayed scattered obstructive apneas
and hypopneas to yield an overall index of 10 events per hour. These events were more prevalent
in the supine position with an adjusted index of 33 events per hour. Events were associated with
mild oxyhemoglobin desaturation to a low of 88%. Snoring was mild in intensity. Sleep
fragmentation was also mild. The patient slept predominantly in the right decubitus position
although some time was spent in the supine position.
In the second therapeutic portion of study the patient was started on CPAP at 5 CWP using a
nasal pillows interface. He was titrated to a final pressure of 7 at which it was good control in
REM sleep and in none-supine position. However REM sleep in the supine position was not
achieved. Periodic limb movements were insignificant. Rhythm was normal sinus with scattered
PVCs and PACs. His morning questionnaires stated that he slept worse than usual. He
complained of irritation from nasal pillows.
DIAGNOSIS:
Mild disordered breathing with an overall index of 10 events per hour jumping to 33 events per
hour in the supine position and SPO2 Nadir of 88% prior to CPAP initiation. Near adequate
control with CPAP at 7 CWP using nasal pillows interface.
COMMENTS:
It is recommended that the patient is started on auto CPAP with a pressure range of 5-14 CWP
using nasal mask interface and possibly with a chinstrap. He should be followed up clinical
efficacy, comfort and compliance. Weight reduction and positional therapy is also recommended
since the events prevalent in the supine position.
Thank for your kind referral.