Hello David! Thank you for asking on HCM! I passed throug your wife medical history, and I would explain that regarding pulmonary hypertension, when it is really present, first we have to quantify its severity. So the first thing to do is measuring pulmonary hypertension by utilizing cardiac ultrasound. The second thing to do is to investigate a possible reason for development of pulmonary hypertension. Frequently an existing abnormal cardiac condition, mainly left-sided (cardiomyopathy, a valvulopathy, etc) may be the reason for PH (secondary pulmonary hypertension). In that case, properly treating the cause, resolves or decreases PH. But, there exists the possibility of primary pulmonary hypertension (the problem arises in the pulmonary arterial circulation, and in that case it is more difficult to manage the situation. There are some treatment options for primary PH, but the results are not so effective, sometimes elusive. Turning to your wife symptoms, facing her daily snoozing and night sleep disturbances, overweight i would recommend you to pay attention to sleep apnea syndrome, to discuss with a specialist in the field (possibly a neurologist), to rule it out or confirm. It is important to emphasize sleep apnea syndrome differentiation, as it my trigger and coexists with pulmonary hypertension. Hope to have been helpful to you. Greetings! Dr. Iliri