Question

A 60-year-old woman is 63 lb (28 kg) overweight. She comes to her psychiatrist's office with a complaint of increased irritability, noting a fight with her husband over how much sugar he put in her coffee one morning. She is fatigued and naps several times each day. She has no history of psychiatric problems, but adds that her husband now sleeps in the living room because of her snoring. Which one of the following is the most likely cause of the patient's symptoms?

A. Night terrors
B. Major depressive disorder
C. Bipolar disorder
D. Narcolepsy
E. Sleep apnea

Answer 1

The likely cause of the woman's irritability, fatigue, and snoring is sleep apnea, a condition worsened by being overweight and evidenced by symptoms such as loud snoring and daytime sleepiness.

Step-by-step explanation:

The most likely cause of the 60-year-old woman’s symptoms, which include increased irritability, fatigue, and snoring, appears to be sleep apnea. This condition is a common sleep disorder characterized by repeated interruptions in breathing during sleep. Factors that may indicate sleep apnea include her being overweight, which increases the risk of obstructive sleep apnea, and the fact that her husband has noticed snoring and has chosen to sleep in another room, potentially due to loud or abnormal breathing sounds. Given that sleep apnea can lead to poor sleep quality, the symptoms of fatigue, irritability, and the need to nap several times a day line up with this diagnosis. Furthermore, sleep apnea is correlated with a louder snoring pattern, which can disrupt both the patient's and their partner's sleep, further contributing to daytime sleepiness and mood disturbances.