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Obstructive Sleep Apnoea — RACP Adult Medicine MCQ

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EasyRespiratoryObstructive Sleep ApnoeaRACP Adult Medicine

A 68-year-old man with a BMI of 32 presents with snoring, witnessed apnoeas, and excessive daytime somnolence (Epworth Sleepiness Scale 16/24). Overnight polysomnography shows an apnoea-hypopnoea index (AHI) of 35 events/hour. What is the first-line treatment?

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Correct answer: B — Continuous positive airway pressure (CPAP)

Moderate-to-severe obstructive sleep apnoea (AHI ≥15) with symptoms is treated with CPAP as first-line therapy. CPAP eliminates upper airway obstruction, improves daytime somnolence, cognitive function, and quality of life, and reduces cardiovascular risk. Weight loss is an important adjunct but insufficient as sole treatment for moderate-severe OSA. Mandibular advancement splints are an alternative for mild-moderate OSA or CPAP intolerance.

Reference: eTG – 2025 – Respiratory; TSANZ – 2024 – OSA Position Statement