A 7-year-old child is brought by his mother for a school physical. His growth parameters show his height to be fiftieth percentile and his weight to be significantly higher than ninety-fifth percentile. His mother complains that he always seems sleepy during the day and that he has started complaining of headaches. His second-grade teacher has commented that he has difficulty staying awake in class. His mother complains that he wakes up the whole house with his snoring at night. Which of the following is the most appropriate next step in evaluating and managing this condition?

a. Try steroids to decrease tonsillar and adenoid hypertrophy

b. Refer to an otolaryngologist for tonsillectomy and adenoidectomy

c. Arrange for continuous positive airway pressure (CPAP) at home

d. Arrange for home oxygen therapy for use at night

e. Arrange for polysomnography

the answer is below…

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