Answer all of the problem questions that are asked. Use your paper to demonstrate your understanding of the physiology involved. There is a 6 page limit for the paper that does NOT include the title page or reference page/s. Your paper should be in APA format and be sure to cite and reference all evidence with proper APA formatting. Be sure to use professional references that are appropriate for graduate work. Textbooks and the data base “Up to Date” may be good starting places, but it is also recommended that you use primary research articles to answer the problem questions.

1. Rick is 65-year-old man who was prompted by his wife to talk with the Nurse Practitioner in the clinic due to progressively worsening daytime sleepiness over the past couple of years. His wife reports that he has been known to snore most nights during sleep, but that the snoring has become louder and more irregular. She is also concerned because there are more mornings that he is feeling poorly and taking ibuprofen for headaches. He reports his only concern is that his erectile dysfunction has gotten worse. The nurse practitioner in the clinic notes that Rick is afebrile and has normal vital signs except for a BP of 150/90. His BMI is 30 kg/m2 and neck circumference is 41 cm. Other physical exam findings are benign for a 65-year-old male. The nurse practitioner is concerned that Rick is suffering from obstructive sleep apnea.

Problem questions:
1. Explain the pathophysiology of obstructive sleep apnea. What is changing to be abnormal and how does this effect the entire body? (30 pts)
2. What are typical clinical and diagnostic signs and symptoms for this diagnosis? What diagnostic tests would be most helpful to confirm the diagnosis? (10 pts)
3. Why are these clinical signs and symptoms occurring? Link what is seen clinically with the pathophysiology. (30 pts)
4. How is obstructive sleep apnea treated? (20 pts)