Understanding Sleep Disorders: Part 2

After telling the patient you suspect he has insomnia and sleep disordered breathing, you administer a physical examination, which produces the following values:

• Lungs—clear to auscultation
• Cardiovascular system—regular rate and rhythm; normal S₁ and S₂; no murmurs, rubs, or gallops 
• Neck—no carotid bruits and no masses or thyroid gland enlargement
• Tonsil size—2 of 4
• Macroglossia—yes
• High arched palate—no
• Retrognathia—yes
• Modified Mallampati/Friedman position—3+/4
• Nasal septal deviation—none seen overtly
• Nasal alae—mildly incompetent, right > left
• Neck size—17 inches

Based on these findings, he asks you how likely it is he has sleep disordered breathing. What do you tell him?

Email your responses to neurologyeditor@consultant360.com, and be sure to tune into next week’s podcast with Dr Joseph Diamond for the answer!

Read Case Part 1 here: https://www.consultant360.com/exclusive/neurology/sleep-medicine/understanding-sleep-disorders-part-1
Listen to the answer to Case Part 1 here: https://www.consultant360.com/podcast/neurology/sleep-medicine/dr-joseph-diamond-diagnosing-multiple-sleep-conditions.