A 56-year-old male with a BMI of 36 with H/o type 2 DM, hypertension (HT), ischemic heart disease, and COPD presents with shortness of breath for three months. However, his DM, HT and COPD were well under control with medicines and inhalers. On admission, he was dyspneic with a respiratory rate of 20 min. Chest X-ray revealed mild cardiomegaly only. Arterial blood gas study confirmed mild respiratory acidosis due to CO2 retention. Full blood report, serum electrolytes, renal function tests, liver function and inflammatory markers were within normal limits. OSA was diagnosed by significant results obtained from the Epworth sleep scale (score 16/24) and confirmed by polysomnography. The apnea/hypopnea index (AHI) was 34, signifying severe OSA.
The figures show that the patient was offered uvulopalatopharyngoplasty (UPPP) and tongue reduction as a first-line treatment. He attained a good outcome following surgery with 93% peripheral saturation in room air, and he had marked improvement in his symptoms at the review at one-month post-surgery
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