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Obstructive sleep apnoea — RACGP Fellowship MCQ

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ModerateChronic disease managementObstructive sleep apnoeaRACGP Fellowship

A 29‑year‑old man presents with excessive daytime sleepiness, loud snoring and witnessed apnoeas. His BMI is 36 kg/m² and blood pressure is 152/94 mmHg. As a professional driver, what is the most appropriate investigation?

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

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Correct answer: E — Arrange a sleep study and advise the patient about driving risk while excessively sleepy

Answer: A. A sleep study (polysomnography or equivalent) is required to confirm obstructive sleep apnoea in symptomatic patients with risk factors (obesity, hypertension) and high-risk occupations (professional driver). Australian guidance allows GPs to directly order a sleep study without specialist review in such contexts to facilitate timely diagnosis and management. Advising about driving risk is also essential, given the medico-legal and safety implications. Option C is contraindicated, as sedatives can worsen OSA by impairing airway tone and respiratory drive. Option D is not diagnostic for sleep‑disordered breathing. Option B is unsafe because snoring with daytime somnolence is not benign and reflects pathologic OSA. Option A is inappropriate: snoring and apnoeas are not due to infection and antibiotics are not indicated.

Reference: RACGP (2024), Management of obstructive sleep apnoea in primary care; Diagnosis of obstructive sleep apnoea in primary care; Australian Prescriber (2024), Diagnosis and management of obstructive sleep apnoea in adults (overnight sleep study).