A 40-year-old male presents with excessive daytime sleepiness and reports episodes of waking up at night with a racing heart. He is also concerned about decreased sexual desire. His wife reports he snores loudly. What could be the issue and what should be the next steps?
This patient's symptoms suggest the possibility of Obstructive Sleep Apnea (OSA). The episodes of waking with a racing heart could be due to nocturnal arrhythmias associated with OSA. The decreased sexual desire can also be a symptom, as OSA can lead to lower testosterone levels. The next steps would be a formal sleep study to confirm the diagnosis. If OSA is confirmed, initial treatment options typically include lifestyle changes and CPAP therapy. Further assessment of his testosterone levels and cardiac function may also be warranted.