A patient with a history of obesity, snoring, and excessive daytime sleepiness is referred by their Primary Care Physician for a polysomnogram. the intake questionaire reveals frequent naps, caffeine use throughout the day and evening, a variable bedtime, and a score of 18/24 on the Epworth sleepiness scale.
The patient has an overall AHI of 4, an arousal index of 5, and a sleep efficiency of 56%. What is MOST LIKELY cause of excessive daytime sleepiness in this patient?
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