Patient name: Lloyd Seabolt

DOB: august 10, 1969

Study date: February 7, 2022
Sleep technician: James Williams, RPSGT
Scoring technician: James Williams, RPSGT
THERAPEUTIC POLYSOMNOGRAPHY WITH BIBAP ASV TITRATION:
Overnight polysomnography with BIPAP ASV titration was performed on this patient with
previously diagnosed complex sleep apnea. The patient is 52 year old African-American male
with a BMI of 23 approximately. His medications include amlodipine, quetiapine, valproic acid,
isosorbide, Crestor, insulin, gabapentin, Abilify, and Zaleplon.
In the beginning of the study the patient’s waking oxyhemoglobin saturation level in a semi
upright position and on BIPAP ASV began at 98%. Thereafter the patient was awake for 34
minutes prior to sleep onset and then achieved a normal sleep efficiency of 90%. Sheep
architecture showed normal stage 1 of sleep, elevated stage 2 of sleep, absent slow wave sleep
and decreased REM sleep. Latency to REM sleep was normal.
In the beginning of the study the patient was started on BIPAP ASV with EPAP 8, PS minimum
3 and PS maximum 15 using full face mask. Review of polysomnographic data shows that no
further adjustment of the pressure were required. Sleep efficiency was good. No snoring was
heard. Sleep fragmentation was mild. He slept only in the right decubitus position. Insignificant
oxyhemoglobin desaturation were noted. Overall AHI was less than one event per hour for this
therapeutic study. Periodic limb movements were insignificant. Rhythm was normal sinus. His
morning questionnaires stated that he slept worse than usual.
DIAGNOSIS:
Adequate control of complex sleep apnea with BIPAP ASV, EPAP 8, PS minimum 3 and PS
maximum 15 using a full faced mask.
COMMENTS:
The patient has complex sleep apnea as documented on the previous split night
polysomnography form November 20, 2021. With BIPAP ASV there is very good control. It is
recommended that the patient be started on the above mentioned settings of BIPAP ASV using a
full face mask and followed up clinical efficacy, comfort and compliance. Attention to any sleep
hygiene issues was recommended.
Thank you for your kind referral.