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Obstructive sleep apnoea syndrome — SCE Respiratory MCQ

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ModerateSleep MedicineObstructive sleep apnoea syndromeSCE Respiratory

A 52-year-old lorry driver reports loud snoring, witnessed apnoeas and sleepiness while driving. BMI is 36 kg/m2, Epworth Sleepiness Scale is 18 and home respiratory polygraphy shows oxygen desaturation index 42/hour. What is the most appropriate ventilation strategy?

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Correct answer: A — Start CPAP and advise on driving restrictions until symptoms are controlled

Severe symptomatic OSAHS with safety-critical sleepiness should be treated with CPAP and the patient advised about driving risk and relevant restrictions. Oxygen and modafinil do not treat upper airway obstruction, while mandibular devices are generally alternatives for less severe disease or CPAP intolerance. Bilevel NIV is considered when hypoventilation or hypercapnia is present rather than uncomplicated OSAHS.

Reference: NICE NG202; DVLA medical standards