A 44-Year-Old Man Arrives at the Office Complaining of Weariness

A 44-year-old man arrives at the office complaining of weariness for the previous six months. He claims, "I've fallen asleep at work a few times, and I had to force myself to focus. I'm having trouble sleeping as well since I keep waking up." The patient feels bad about spending less time with his children because he is fatigued, and he reports that his mood has been poor for the previous week. He is concerned that his wife is irritated with him since he has not been contributing as much to home tasks and keeps her up at night owing to his snoring. The patient consumes three or four beers each week and does not use cigarettes or illegal substances. Medical history is noncontributory.  Blood pressure is 146/94 mm Hg and pulse is 78/min and regular.  BMI is 32 kg/m².  Which of the following is the most likely diagnosis?

A) Major depressive disorder
B) Narcolepsy
C) Obstructive sleep apnea
D) Primary insomnia
E) Somatic symptom disorder

Correct Answer:

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