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Obstructive sleep apnoea — RACP Written MCQ

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HardRespiratoryObstructive sleep apnoeaRACP Written

A 48-year-old man has loud snoring, witnessed apnoeas and morning headaches. BMI is 36 kg/m2, Epworth Sleepiness Scale is 18 and serum bicarbonate is 32 mmol/L. Spirometry is normal. What is the most appropriate investigation?

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Correct answer: B — Overnight polysomnography with assessment for hypoventilation

Marked sleepiness with witnessed apnoeas suggests obstructive sleep apnoea; raised bicarbonate raises concern for obesity hypoventilation, so overnight testing with gas-exchange assessment is appropriate.

Reference: Australian Asthma Handbook; TSANZ guidance; Therapeutic Guidelines: Respiratory