A 48-year-old man comes to the physician because of difficulty concentrating at work and generalized fatigue for the past 5 months. During this period, he has often fallen asleep while watching his favorite TV show. His wife reports that he snores loudly and sometimes stops breathing for a few seconds while asleep. He has hypertension treated with metoprolol. He has smoked one pack of cigarettes daily for 30 years. He is 168 cm (5 ft 5 in) tall and weighs 87 kg (192 lb); BMI is 31 kg/m2. His temperature is 37.1°C (98.8°F), pulse is 88/min, respirations are 14/min, and blood pressure is 135/85 mm Hg. Physical examination shows no abnormalities. Arterial blood gas analysis is normal. What is this patient's most likely diagnosis?

Question

A 48-year-old man comes to the physician because of difficulty concentrating at work and generalized fatigue for the past 5 months. During this period, he has often fallen asleep while watching his favorite TV show. His wife reports that he snores loudly and sometimes stops breathing for a few seconds while asleep. He has hypertension treated with metoprolol. He has smoked one pack of cigarettes daily for 30 years. He is 168 cm (5 ft 5 in) tall and weighs 87 kg (192 lb); BMI is 31 kg/m2. His temperature is 37.1°C (98.8°F), pulse is 88/min, respirations are 14/min, and blood pressure is 135/85 mm Hg. Physical examination shows no abnormalities. Arterial blood gas analysis is normal.  What is this patient's most likely diagnosis?

Quizplus · Accepted Answer

Eductional Objective: Obstructive sleep apnea is due to relaxation of oropharyngeal muscle tone with occlusion of the upper airway.  Symptoms include daytime sleepiness, headaches, and depression.  Complications include systemic and pulmonary hypertension, right heart failure, and an increased risk for cardiac events.

A 48-Year-Old Man Comes to the Physician Because of Difficulty