A 62-year-old male patient with COPD is being seen in the pulmonary clinic for dyspnea at rest and daytime hypersomnolence
The patient has been hospitalized three times in the past year for COPD exacerbations and once for pneumonia. He currently uses 2 L/min oxygen from a concentrator all the time. The patient reports that he is able to sleep only about 2 hours each night and that he has a headache every morning. Which of the following should be recommended to the physician?
a. Chest cuirass
b. Nocturnal NIV
c. Nocturnal CPAP
d. Tracheostomy and ventilation
ANS: B
This patient shows signs of nocturnal hypoventilation and poor sleep quality, as evidenced by the daytime hypersomnolence, dyspnea, and morning headache. This patient should be assessed fur-ther for the use of nocturnal NIV by testing for oxygen saturation overnight.
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