Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is the recommended first-line treatment for sleep apnea?

1. Surgery

2. Weight loss

3. Continuous positive airway pressure (CPAP)

4. Oral appliance therapy

The correct answer is: Continuous positive airway pressure (CPAP)

Continuous positive airway pressure (CPAP) is recognized as the first-line treatment for obstructive sleep apnea (OSA), which is the most common type of sleep apnea. The CPAP machine helps keep the airway open during sleep by providing a continuous stream of air, thereby preventing episodes of apnea. This intervention is supported by a significant body of research demonstrating its efficacy in reducing daytime sleepiness, improving overall quality of life, and decreasing the risk of associated complications, such as cardiovascular issues. The other treatment options have specific indications but are typically considered second-line or adjunctive treatments. Weight loss can be beneficial, especially for patients whose OSA is significantly exacerbated by obesity; however, it is not the primary treatment modality recommended for all patients. Surgery may be indicated in select cases, particularly when there are anatomical issues contributing to airway obstruction, but it is not the first approach for most patients. Oral appliance therapy can be effective for some individuals, particularly those with mild to moderate OSA, or for those who cannot tolerate CPAP, but it's generally not prioritized above CPAP therapy for first-line treatment. Thus, CPAP stands as the gold standard in the management of sleep apnea.