Paul - Paul Paul is a 52-year-old man referred for...

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Paul 1 of 2 Paul is a 52-year-old man referred for evaluation of excessive daytime sleepiness. He reports a long-standing problem with sleepiness going back to early childhood that has worsened over the past several years. He falls asleep in almost any low-stimulation situation (e.g., meetings at work, talking to customers, doing paperwork, watching television or a movie, or attending church). On several occasions, he has fallen asleep while driving and once had a serious accident as a result. His sleep episodes are typically brief, lasting only a few minutes, and are more likely to occur in the afternoon or evening hours. When he falls asleep during the day, he does not find sleep particularly refreshing and does not recall dreaming. Paul falls asleep three to five times on most days. Upon careful questioning, he denies episodes of muscle weakness with intense emotion, sleep-related hallucinations, or paralysis. Paul regularly goes to bed at about 10:30 P.M., falls asleep almost immediately, and awakens at 7 A.M. He typically has one or two brief awakenings during the night. He works 12-hour shifts as the manager of a discount store but works only during daylight hours. His wife does note some snoring, although this has never been excessively loud and is reduced when he rolls over on
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Paul - Paul Paul is a 52-year-old man referred for...

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