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A 56 years male, smoker with BMI 42 kg/m 2 complaints of excessive snoring, choking spells, frequent night time awakenings for urination, evident daytime sleepiness with a recent history of near miss road traffic accident while driving on highway. He gave history of frequent alcohol consumption. He also had poorly controlled diabetes and hypertension. Despite all efforts, he was unable to lose weight. On examination, he had retrognathia, crowded oropharynx and neck circumference of 19 inches. PSG showed lowest spO 2 69%, AHI 48/hr, REM AHI 62/hr.
Pralhad Prabhudesai (Fri,) studied this question.