July 2022 Sleep Case of the Month: A Sleepy Scout

Christine S. Fukui MD

Honolulu, HI USA

History of Present Illness:

A 25-year-old African American man complaining of excessive daytime somnolence. He was a US Army Ranger scout who received a traumatic brain injury (TBI) from an improvised explosive device attack in Afghanistan which resulted in a loss of about ¼ of his visual field. He said he slept well at night and there was no history of snoring. There was no history of any parasomnias.

PMH, SH, FH:

Other than the traumatic brain injury there was no significant PMH. His most recent brain scan showed only the remnants of his brain injury which resulted in an intracerebral hemorrhage which was managed conservatively. He was single. He did not smoke and had only moderate alcohol intake. There was no significant FH of sleep apnea.

Physical Examination:

Other than the visual field loss his physical examination was unremarkable.

What should be done next? (Click on the correct answer to be directed to the second of five pages)

1. Brain MRI
2. Electroencephalogram (EEG)
3. PSG (polysomnography) sleep study
4. Repeat CT of head
5. All of the above

Cite as: Fukui CS. July 2022 Sleep Case of the Month: A Sleepy Scout. Southwest J Pulm Crit Care Sleep 2022;25(1):1-3. doi: https://doi.org/10.13175/swjpccs027-22 PDF