USMLE Step 2 Quiz
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PULMONOLOGY
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A 70-year-old man with a history of systolic heart failure (ejection fraction 35%) is evaluated for daytime sleepiness and fatigue. His wife reports his breathing at night is irregular, with periods of rapid, deep breathing alternating with periods where he stops breathing entirely. A sleep study confirms Cheyne-Stokes respiration with a central apnea-hypopnea index of 25 events/hour. He is on optimal medical therapy for his heart failure.
Which of the following is the most appropriate initial therapy for this patient's sleep-disordered breathing?
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