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COPD Escalation — SCE Respiratory MCQ

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Hard"Respiratory Medicine"COPD EscalationSCE Respiratory

A patient with obstructive sleep apnoea remains excessively sleepy despite documented CPAP use throughout sleep and a residual AHI of 2/hour. What is the best next step?

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Correct answer: A — Investigate reversible causes of residual sleepiness

Residual sleepiness requires confirmation of adequate CPAP use and sleep opportunity, followed by assessment for sedating medicines, depression, circadian problems, limb movements, narcolepsy and other medical causes. Wake-promoting therapy is a specialist decision after reversible explanations are addressed.

Reference: https://www.brit-thoracic.org.uk/quality-improvement/guidelines/