question: Q:A 54-year-old man comes to the physician because of excessive daytime sleepiness for 5 months. He wakes up frequently at night, and his wife says his snoring has become louder. He is 180 cm (5 ft 10 in) tall and weighs 104 kg (230 lb); his BMI is 33 kg/m2. His pulse is 80/min and his respiratory rate is 11/min. His jugular venous pressure is 7 cm H2O. He has 2+ pitting edema of the lower legs and ankles. Arterial blood gas analysis on room air shows a pH of 7.42 and a PCO2 of 41 mm Hg. An x-ray of the chest shows normal findings. Which of the following is the most likely underlying cause of this patient's condition?? 
  {'A': 'Increased medullary ventilatory responsiveness', 'B': 'Impaired myocardial relaxation', 'C': 'Decreased levels of hypocretin-1', 'D': 'Intermittent collapse of the oropharynx', 'E': 'Daytime alveolar hypoventilation'},