Daytime sleepiness

A 21-year-old College student came to the clinic complaining of tiredness, daytime sleepiness, and difficulty swallowing for the past six months. Last semester she had difficulty passing her exam due to a lack of energy for studying during the day and frequently getting in an argument with her roommate for loud snoring. Her past medical history indicates recurrent upper respiratory tract infections. She denies painful swallowing, and her temperature is 37.2 C.  Her physical examination revealed halitosis, noisy respirations with an open mouth, and tonsillar swelling, as shown in the picture. No cervical lymphadenopathy, pharyngeal erythema, or neck pain. Based on given history and physical examination,