NEUROLOGY

A 50-yr-old man presented é daytime somnolence, anxiety & a feeling of breathlessness esp when lying flat, which had ↑d over 6 wks. There was no h/o lung dise. He was uncertain if he snored at night. He now sat up to sleep. Exam showed a BMI of 35 kg/m2 (18-25), collar size of 18 inches (46 cm) & no spinal abnormality. Neurological & cardiac examinatns were normal. He seemed very anxious, panicky, tachypneic & was hyperventilating. He refused to lie down to be examined, insisting that he would not be able to breathe. Ixs : ECG normal forced vital capacity : sitting 3.0 L semi-recumbent 1.2 L What is ′most likely cause of his sym ?

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