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Shift Work Sleep Disorder — SCE Neurology MCQ

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HardSleep DisordersShift Work Sleep DisorderSCE Neurology

A stable ambulatory man has BMI 48 kg/m², daytime PaCO2 6.5 kPa and severe OSAHS (AHI 52/hour). He has no acute ventilatory failure. Which is the recommended first-line nocturnal ventilatory treatment?

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Correct answer: C — Nocturnal oxygen alone with reassessment of daytime hypercapnia after three months

In stable ambulatory obesity hypoventilation syndrome with severe coexistent OSAHS, NICE recommends CPAP as first-line treatment. NIV is considered when severe OSAHS is absent or when CPAP is inadequate. Oxygen alone does not correct hypoventilation, and wake-promoting medication cannot replace treatment of the underlying ventilatory disorder.

Reference: NICE NG202: obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome: https://www.nice.org.uk/guidance/ng202/chapter/2-Obesity-hypoventilation-syndrome