Friday, April 9, 2010

Tired

A 45 year old man presents with fatigue, your favorite chief complaint. The fatigue has been getting worse over the last few months. He's just been so sleepy during the daytime, especially when doing boring, passive, or monotonous activities. He even admits to dozing off while reading, watching television, and driving. Last week, he fell asleep and began snoring at church which embarrassed him. When you delve deeper, it's not that he doesn't have energy, he just falls asleep. Sometimes at night, he wakes up with a sensation of choking, gasping, or smothering. He also complains of a dry mouth while asleep and often has restless, fitful sleep. He has a past medical history of obesity, hypertension, coronary artery disease, chronic renal insufficiency, type 2 diabetes mellitus, and GERD. Review of systems is positive for decreased sex drive, headaches in the morning, and poor concentration. He denies feeling depressed.

Challenge: With just the history, what's your diagnosis?

9 comments:

NN said...

Sleep Apnea?

Eric said...

Sleep apnea

shabnam sharan said...

Obstructive Sleep Apnoea

Suheil said...

Obstructive Sleep Apnoea Syndrome

Anonymous said...

sleep apnea?

Elden said...

a form of sleep apnea (OSA)?

Alex said...

osa

Robingebbie said...

Obstructive Sleep Apnea (OSA)

Craig Chen said...

yes! you guys are all right! i should have tossed in some red herrings :)
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Tired

This is obstructive sleep apnea due to collapse of the upper airway during sleep.

Source: UpToDate.