ABSTRACT

He is overweight with a large jaw and thick beard. Airway examination reveals poor dentition, a large tongue, and a Mallampati score of 3.

Blood investigations Awaited

Arterial blood gas pH 7.38 pO2 8.69 kPa pCO2 6.98 kPa BE +4.8 HCO3 32 mmol/L Hb 17 g/dl

Chest X-ray done two months ago

Sleep studies done two months ago

The polysomnogram demonstrated an apnoea-hypopnoea index (AHI) of 15 events/hr and a nadir oxygen saturation of 78%; supine AHI was 44 events/hr. Definitive obstructive events were not observed in the nonsupine position. The total sleep time was 337 minutes, with a sleep time in the supine position of 113 minutes. A 2-minute epoch from the patient’s polysomnogram is shown in Figure 1.2.