What is the next best step when a patient complains of claustrophobia, is unable to tolerate PAP, and requests to end the PSG?

When a patient expresses issues with claustrophobia and wishes to end a polysomnography (PSG) session due to discomfort with positive airway pressure (PAP) therapy, scheduling desensitization is the most appropriate next step. Desensitization techniques can help the patient gradually become accustomed to the equipment and reduce their anxiety related to it. This approach focuses on addressing the root of the patient's discomfort in a controlled and supportive environment.

Providing a different mask may temporarily alleviate physical discomfort, but it does not address the underlying psychological factors associated with claustrophobia. Similarly, while encouraging deep breathing can be a useful relaxation technique, it may not be sufficient for someone with significant fears or anxiety about the PAP equipment. Administering sedatives, while it might seem to provide immediate relief, can complicate the patient's response to treatment and doesn't help them overcome their fear of the equipment long-term.

In summary, scheduling desensitization is a proactive and therapeutic way to assist the patient in overcoming their claustrophobia, ultimately leading to a more successful and cooperative experience with the PSG.