1 oft ACCLI SarTY HOME SLEEP TEST REPORT provided by NovaSorn" Patient Name: JEFFREY EPSTEIN Test ID: ORD-512625 Date of Birth: 01/20/1953 Dates of Study: 06/27/2014 Gender: Male Referring Clinician: BRUCE MOSKOWITZ, Height, Weight: 72.0 in, 200.0 lbs Ordering Clinician: BRUCE MOSKOWITZ, SSN Number: Interpreting Physician: Michael Coppola MD FCCP Symptoms This 61 y/o Male was referred for the following complaints: Snoring, Excessive Daytime Sleepiness BMI 27.12 inches, Neck Size Not provided, Epworth 16.00 Diagnosis: Moderate Obstructive Sleep Apnea (ICD-9: 327.23, ICD-10: G47.33) Interpretation and Recommendation `This study confirms the presence of physiologic events consistent with moderate obstructive sleep apnea (OSA) with frequent hypopneas and apneas. The diagnosis of obstructive sleep apnea syndrome requires the presence of historical data such as excessive daytime sleepiness or witnessed snoring and apneas at night in addition to sleep recordings documenting a significant level of sleep disordered breathing. This study confirms those criteria and treatment for sleep apnea is indicated. Auto-titrating CPAP (continuous positive airway pressure) or a CPAP titration would be appropriate. Other effective treatments which may be considered are oral appliances and otolaryngeal evaluation for treatable upper airway narrowing. Treatment would also include careful attention to proper sleep hygiene, weight reduction if the BMI is elevated, avoidance of sleeping in the supine position and avoidance of alcohol within four hours of bedtime. Specific treatment decisions should be tailored to each patient based upon the clinical situation and all treatment options should be considered. The patient should be instructed to avoid driving if sleepy and careful clinical follow up is needed to ensure that the patient's symptoms are improving with therapy and that PAP adherence is supported and measured if prescribed. Although different in