A 45-year old male presents with complaints of daytime somnolence and forgetfulness. His wife reports that her husband snores loudly during night with intermittent periods of breath holding. Which of the following is a most likely diagnosis?
  1. Narcolepsy
  2. Coronary artery disease
  3. Obstructive sleep apnea
  4. Cushing’s syndrome
Explanation
Answer- C - Most likely diagnosis is obstructive sleep apnea. Symptoms of obstructive sleep apnea are daytime somnolence, headache, depression, forgetfulness, overweight, and impotence. An electrocardiogram may indicate bradydysrhythmia during apnea and tachydysrhythmia during respiration. Erythrocytosis, hypertension, and heart failure are common. Narcolepsy is characterized by brief, sudden episodes of falling asleep, loss of muscle tone, and sleep paralysis. Cushing’s syndrome will have its other typical feature.
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