CV

Walter Spence, RPSGT Richmond, VA · walt@waltspence.com · LinkedIn · GitHub

Registered Polysomnographic Technologist with more than 20 years in sleep medicine and over 15,000 studies of every type, focusing on alternative therapies, with a specialty in pediatrics. I lead the hypoglossal nerve stimulation (HGNS) program at St. Mary’s Hospital, with nine years of hands-on Inspire HGNS experience, from overnight titration through long-term follow-up. I also build and run AI agent systems and the software around them.

Open to clinical and engineering roles, remote preferred.

Clinical experience

Registered Polysomnographic Technologist, Daytime

Bon Secours Mercy Health, Richmond, VA · July 2025 to present

• Leads the hypoglossal nerve stimulation (HGNS) program at St. Mary’s Hospital.
• Daytime testing operations and physician workflow, including study readiness and documentation.
• Also covers overnight Inspire titration studies and implanted-patient follow-up.
• Lab-side clinical reference for implanted patients: device education, comfort and adherence troubleshooting, and escalation to the implanting team.

Overnight Registered Polysomnographic Technologist

Virginia Commonwealth University Health, Richmond, VA · 2024 to 2025

• Returned to pediatric sleep medicine, which I had worked in early in my career.
• Overnight testing in a high-acuity academic medical center, including pediatric patients with complex neurological, genetic, respiratory and behavioral conditions.
• Accurate physiological data collection, real-time monitoring and protocol compliance for vulnerable patients.
• Trained and mentored new technologists in electrode application, study protocol, scoring criteria and EMR use.
• Tracked, calibrated and troubleshot diagnostic equipment.

Daytime Registered Polysomnographic Technologist

Pulmonary Associates of Richmond, Richmond, VA · 2024

• Multiple Sleep Latency Tests and reports for physician review.
• Patient education on PAP compliance and long-term therapy, and follow-up for Inspire patients.
• Scoring and interpretation workflow, including DME setup.

Overnight Registered Polysomnographic Technologist

Community Health Systems / Bon Secours Mercy Health, Richmond, VA · 2020 to July 2025 (PRN from 2024)

• Overnight Inspire titration studies and implanted-patient care across the full follow-up cycle.
• Electrode application and overnight monitoring, with attention to scoring protocol and patient comfort.
• Technical operations of the sleep lab, including equipment readiness and data quality.

Overnight Polysomnographic Technician

Sleep Clinics of America, Richmond, VA · 2017 to 2020

• Inspire titration studies and implanted-patient follow-up alongside standard diagnostic polysomnography.
• Diagnostic accuracy and patient comfort across high-volume overnight studies.

Earlier sleep laboratory roles

• Sleep 360, Austin, TX · 2016
• Virginia Medical Group, Colonial Heights, VA · 2014 to 2016
• Bon Secours Health Source, Richmond, VA · 2010 to 2014
• River City Sleep Medicine (Neurological Associates), Richmond, VA · 2008 to 2010
• Sleep Disorders Center of VA, Colonial Heights, VA · 2003 to 2008

Engineering and business

Independent web developer and consultant

Web and AI agent systems · 2004 to present

• Contract web development since 2004; for the last five years, consulting and individual-contributor work on web and AI agent systems alongside sleep medicine.
• zap: a terminal-native app uninstaller for macOS and Linux. On its first run on my own machine, it freed over 20 GB.
• Helix: a multi-node fleet of AI agents across Linux and macOS, with a scheduled loop that finds recurring failures, tests fixes and ships them behind a rollback. See Supposed to Run Itself.
• Knowfer: a Rails knowledge base that agents read and write over MCP.
• Talkify: a Rails and Vue 3 dashboard for running agents.
• waltspence.com: this site and its publishing desk, on Rails, Vue 3, Redis, and Python and Node workers.

Founder and CEO

EnLab, LLC · 2010 to 2016

• Founded a startup focused on a WebRTC meeting project.

Certifications

• RPSGT, Registered Polysomnographic Technologist (Board of Registered Polysomnographic Technologists)
• BLS, Basic Life Support
• Licensed in Virginia and North Carolina

Education

• Coursework, Richard Bland College of William & Mary, Petersburg, VA
• High school diploma, Dinwiddie County High School, Dinwiddie, VA

Skills

• Clinical: polysomnography of every study type (adult, pediatric, high-acuity), hypoglossal nerve stimulation (HGNS) titration and follow-up with Inspire, MSLT, PAP therapy and compliance education, AASM scoring
• Technical: neurostimulator titration workflow, electrode application and troubleshooting, diagnostic equipment calibration and maintenance
• Software: Ruby on Rails, Python, JavaScript and Vue, Shell, PostgreSQL, Redis, Docker, Linux and macOS administration, LLM integration and agent systems