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Obesity hypoventilation syndrome — SCE Respiratory MCQ

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HardSleep MedicineObesity hypoventilation syndromeSCE Respiratory

A stable patient with obesity hypoventilation has daytime PaCO2 7.4 kPa and sustained nocturnal hypoventilation, but only mild obstructive sleep apnoea. Which long-term nocturnal support is preferred?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Non-invasive ventilation

When OHS is driven predominantly by hypoventilation rather than severe OSA, nocturnal NIV is preferred because it provides pressure support and improves ventilation. CPAP is generally first-line when severe OSA is the dominant phenotype.

Reference: NICE NG202: Obstructive sleep apnoea and obesity hypoventilation syndrome. https://www.nice.org.uk/guidance/ng202/chapter/recommendations