Question

A 32-year-old morbidly obese male complains of excessive fatigue, snoring, and awakening in the middle of the night, which prevents restorative sleep. He is sluggish during the day due to the lack of sleep and feels like he is going "fall asleep at the wheel" when driving to work. Occupation: dishwasher. Medical history includes hypertension and type 2 diabetes. Current medications include ACE inhibitor and metformin. Denies use of alcohol, tobacco, or drugs. On physical examination, the patient is afebrile, pulse 88, resps 20/min, BP 178/95. BMI is 45. These are signs and symptoms of: A. Obstructive sleep apnea B. Primary insomnia C. Heart failure D. All of the above

Answer 1

Based on the symptoms described, the signs and symptoms of the 32-year-old morbidly obese male are consistent with obstructive sleep apnea (OSA). OSA is a sleep disorder characterized by pauses in breathing or shallow breaths during sleep. It occurs when the muscles in the back of the throat fail to keep the airway open, leading to interrupted breathing and reduced oxygen levels.

The excessive fatigue, snoring, and awakening in the middle of the night that prevents restorative sleep are common symptoms of OSA. The patient's sluggishness during the day and the feeling of potentially falling asleep at the wheel while driving to work are also indicative of the lack of quality sleep.

The patient's occupation as a dishwasher is not directly relevant to the symptoms of OSA, but it may be worth noting that certain occupations that involve prolonged sitting or sedentary behavior can contribute to obesity and the development of OSA.

The patient's medical history of hypertension and type 2 diabetes, as well as his current medications, ACE inhibitor and metformin, are also factors that can contribute to the development of OSA. Obesity, hypertension, and type 2 diabetes are known risk factors for OSA.

Based on the information provided, the correct answer is A. Obstructive sleep apnea.