Thank you for referring Sergio Caramanico, a 56 year-old gentleman who operates a manufacturing business. Sergio generally works ten hours per day. He is an ex-smoker of approximately 30 pack years and consumes alcohol on average two standards drinks each evening. Regular medications include allopurinol, Atacand and Liptor.
As you are aware, around three weeks ago, Sergio was involved was involved in a motor vehicle accident where it seems he had a micro-sleep behind the wheel after driving through a round about. His can drove through a fence and was written off. Fortunately, Sergio himself was not injured. The episode occurred at around 3.00pm and on that day, at around midday, Sergio had a cortisone injection to his knee to deal …show more content…
There is a history or snoring, witness apnoeas but no nocturnal choking/gasping episodes. He often reports fragmented sleep and intermittent nocturia. He occasionally experiences sleep maintenance insomnia. When Sergio wakes at 5.10am, he feels variably refreshed and does report variable daytime somnolence with a tendency to fall off to sleep when engaged in passive activities. He generally avoids daytime naps. He does report chronic right-sided nasal congestion and has a perforated nasal septom from previous cortisone use. He has gained around 10-15kg over the last five years, and this correlates to an increase in symptoms.
Examination revealed blood pressure of 130/80 and oropharyngeal inspection was notable for crowding (Mallampati class 2). Cardiorespiratory examination was unremarkable.
Assessment:
Sergio presents with a high pre-test probability of obstructive sleep apnoea and I have arranged an urgent diagnostic sleep study through the Austin Hospital. I have advised Sergio that he should not be driving until this matter has been dealt with. In due course, he will also need to notify VicRoads of a sleep apnoea diagnosis if this is confirmed. He does not seem overly keen on the potential scenario of being treated with CPAP but understands the importance of this.
I will see him again, hopefully in the next couple of weeks once the sleep study has been completed.
Thank you again for your
As you are aware, around three weeks ago, Sergio was involved was involved in a motor vehicle accident where it seems he had a micro-sleep behind the wheel after driving through a round about. His can drove through a fence and was written off. Fortunately, Sergio himself was not injured. The episode occurred at around 3.00pm and on that day, at around midday, Sergio had a cortisone injection to his knee to deal …show more content…
There is a history or snoring, witness apnoeas but no nocturnal choking/gasping episodes. He often reports fragmented sleep and intermittent nocturia. He occasionally experiences sleep maintenance insomnia. When Sergio wakes at 5.10am, he feels variably refreshed and does report variable daytime somnolence with a tendency to fall off to sleep when engaged in passive activities. He generally avoids daytime naps. He does report chronic right-sided nasal congestion and has a perforated nasal septom from previous cortisone use. He has gained around 10-15kg over the last five years, and this correlates to an increase in symptoms.
Examination revealed blood pressure of 130/80 and oropharyngeal inspection was notable for crowding (Mallampati class 2). Cardiorespiratory examination was unremarkable.
Assessment:
Sergio presents with a high pre-test probability of obstructive sleep apnoea and I have arranged an urgent diagnostic sleep study through the Austin Hospital. I have advised Sergio that he should not be driving until this matter has been dealt with. In due course, he will also need to notify VicRoads of a sleep apnoea diagnosis if this is confirmed. He does not seem overly keen on the potential scenario of being treated with CPAP but understands the importance of this.
I will see him again, hopefully in the next couple of weeks once the sleep study has been completed.
Thank you again for your