Last updated on: March 1st, 2023

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You’re looking at a multiple-choice question from QBank Prepper (the newest of four distinct learning formats available in Clinical Odyssey). Try it out, and have fun improving your clinical skills.

Obstructive airway disease 5

A 64-year-old man comes into the clinic for a follow-up appointment. His first visit was 2 weeks back. His partner asked him to come in after multiple complaints of his “waking the neighbors up with his snoring” and his dozing off at any opportunity during the day. This had gone on for about 8 months. He had nodded off once or twice while stopped in traffic, but never while actively driving. He makes regular trips to the dentist for a severe temporomandibular joint disorder. Four months ago, he was diagnosed with hypertension and type 2 diabetes mellitus, for which he takes ramipril and metformin respectively, with fair control. His temperature is 36.5 ˚C (97.7 ˚F), pulse is 80/min, respirations are 18/min, and blood pressure is 146/88 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 97%. His BMI is 29.6 kg/m2. He scores 11 on the Epworth sleepiness scale. A polysomnography result shows an apnea/hypopnea index (AHI) of 8, with no significant difference when he changes his sleep position. He has read about continuous positive airway pressure (CPAP) but is unsure if he can tolerate the dryness.

Which of the following is the most appropriate next step?

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