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A 65 year old recently retired male presenting with persistent daytime sleepiness requires a systematic geriatric evaluation because sleep disturbances in older adults are often multifactorial. Age-related changes in sleep architecture include reduced slow wave sleep, increased sleep fragmentation, and earlier sleep onset and awakening. However, excessive daytime sleepiness is not a normal consequence of aging and warrants clinical assessment. The patient has significant comorbidities including hypertension and dyslipidaemia and is overweight with a height of 5 feet 8 inches and weight of 96 kg. His body mass index is approximately 32 kg/m², placing him in the obese category. Obesity is an important risk factor for several sleep disorders, particularly obstructive sleep apnoea and gastroesophageal reflux disease. Although there is no history of snoring, choking, or witnessed apnoeic episodes, absence of classical symptoms does not completely exclude sleep-related breathing disorders in older adults. Nevertheless, the wife’s report of frequent night-time cough, along with morning hoarseness ____ _______ ________ ___ __________ _________ _______ ___ __________ ____ ____.
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