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Obstructive sleep apnea CPAP follow-up — USMLE Step 3 MCQ

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HardAmbulatory Medicine / Primary CareObstructive sleep apnea CPAP follow-upUSMLE Step 3

A 52-year-old man comes for follow-up of obstructive sleep apnea. He has used CPAP for 3 months. Downloaded data show use on 85% of nights for 6.5 hours/night with residual apnea-hypopnea index of 3/hour. He reports improved daytime alertness but persistent hypertension at 146/88 mm Hg. BMI is 36 kg/m2. Which of the following would you recommend at the follow-up visit?

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Correct answer: B — Continue CPAP and intensify weight loss and blood pressure management

Effective CPAP should be continued when adherence and residual AHI are good. Persistent cardiometabolic risk should be addressed with weight loss and hypertension management rather than stopping CPAP.

Reference: American Academy of Sleep Medicine obstructive sleep apnea guidance