The decision to treat obstructive sleep apnoea turns as much on symptoms as on the apnoea-hypopnoea index. Ask about daytime sleepiness, unrefreshing sleep, nocturia and drowsy driving, and use a structured score such as the Epworth Sleepiness Scale. A sleepy patient has the clearest benefit; a patient without symptoms needs a shared decision.
- Record an Epworth score or equivalent at diagnosis.
- Ask specifically about drowsiness while driving.
- Review symptoms again after starting CPAP to judge benefit.
Why it matters
Sleepiness both predicts benefit and drives adherence.
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