TASK 7 Name            :           Kim Morley               Age      :           36

Admitted        :           10 November 2008                  Discharged     :           11 November 2008

Reason for admission Minor RTA after falling asleep at the wheel-
Diagnosis OSA

HISTORY:  Loud snoring, excessive daytime sleepiness; depression; father had OSA; obese 150 kgs- no weight reduction techniques successful over last 5 years. No history of asthma, emphysema or chronic cough suffered from gout two years ago and psoriasis: alcohol 3-4 glasses daily, usually wine; up to four coffees/day; no medications; Divorced, 2 children; builder owns own business; smoker- 1 pk/day 15 years; had malaria 1998, appendix out 1990. No allergies.

Examination: Sleep study (overnight/daytime split night polysomnography) confirmed OSA, face mask used claustrophobia and discomfort so nasal trumpets used. EEG, EOG, chin and leg EMG EKG airflow, thoracic and abdominal recorded. Pt. given Ambien for test.

 Discharge Plan: Avoid sedatives, hypnotics and narcotics unless sleep apnoea treated. No operation of heavy machinery or driving unless sleep apnoea treated See dietitian re: weight loss plant, healthy diet, exercise

Use heated humidifier in bedroom

Give up Smoking – Given info about Quit program Cut down alcohol and caffeine. Use nasal decongestant

See sleep disorder specialist for a CPAP machine.

Writing Task: Using the information in the case notes. Write a letter of referral to the sleep disorder specialist, Mrs. Ton wisdom, 23 Wellman St. Camberwell, 330

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