Review Question - QID 210756

A 43-year-old man presents to a primary care clinic complaining of several months of fatigue and difficulty concentrating at work. He is tired throughout the day and often falls asleep briefly at work. He sleeps for 9 hours per night, falling asleep easily, waking up several times in the middle of the night, and then having trouble waking up in the morning. His past medical history is significant for hypertension and dyslipidemia. His medications include lisinopril and atorvastatin. He drinks 2 drinks per day and does not smoke. Physical exam is notable for obesity and a large neck circumference. His temperature is 98°F (36.7°C), blood pressure is 150/90 mmHg, pulse is 75/min, respirations are 22/min, and BMI is 33 kg/m^2. The rest of the physical exam is normal. Which of the following is the most likely cause of his fatigue?