Clinical Intake — Obstructive sleep apnea

A 54-year-old male presents with a 12-month history of loud snoring, witnessed apneas reported by his spouse, and significant daytime somnolence with an Epworth Sleepiness Scale score of 14. Attended sleep study confirmed moderate-severe obstructive sleep apnea with an apnea-hypopnea index of 22 events per hour and nadir oxygen saturation of 82%. Conservative airway pressure therapy was trialed over three months with documented intolerance — average nightly use of 2.3 hours, complicated by claustrophobia and persistent skin breakdown at the mask interface despite two mask refittings. Pharyngeal examination reveals an elongated soft palate and 3+ tonsillar hypertrophy; the otolaryngologist recommends further evaluation and surgical management.