Ms. GMs. G 25 yobf Height 5’4” Weight 272 lbs.

25 yobf Height 5’4” Weight 272 lbs.

Chief ComplaintChief Complaint EDS - Epworth of 15/24 Nocturnal sleep disruption Shift worker (doesn’t like it) Snoring

EDS - Epworth of 15/24 Nocturnal sleep disruption Shift worker (doesn’t like it) Snoring

Family HistoryFamily History Maternal HTN Mother has had a stroke

Maternal HTN Mother has had a stroke

Obesity Hypoventilation and OSAObesity Hypoventilation and OSA

Excessive weight pushes against diaphragm causing shallow breathing

Baseline SaO2 <88% Low Vt - high respiratory

rate (attempt to maintain normal minute ventilation)

Excessive weight pushes against diaphragm causing shallow breathing

Baseline SaO2 <88% Low Vt - high respiratory

rate (attempt to maintain normal minute ventilation)

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%

10 20 30 40 50 60 70 80 90 10010 20 30 40 50 60 70 80 90 100

Oxyhemoglobin Dissociation CurveOxyhemoglobin Dissociation Curve

SaO

2SaO

2

PO2 mm HgPO2 mm Hg

Oximetry Strip Chart TrendingOximetry Strip Chart Trending

ConclusionConclusion

Severe OSA - Controlled with CPAP 13 cm H20 Patient referred to Pulmonary Department for work-

up Patient referred to ENT specialist

Severe OSA - Controlled with CPAP 13 cm H20 Patient referred to Pulmonary Department for work-

up Patient referred to ENT specialist