# A client newly diagnosed with moderate obstructive sleep apnea is started on home CPAP. Which client statement indicates a need for further teaching?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=374966&lang=en  
> language: en  
> subject: NCLEX-RN  
> category: HPM

## Question

A client newly diagnosed with moderate obstructive sleep apnea is started on home CPAP. Which client statement indicates a need for further teaching?

## Option

1. I will use the CPAP every night for the entire time I sleep
2. I can stop the CPAP once I lose 5 pounds because my apnea will be cured **✔ Correct answer**
3. I should clean the mask and humidifier reservoir regularly per the manufacturer
4. I will follow up with the sleep clinic if I develop nasal dryness or skin breakdown

**Correct answer: 2**

## Explanation

Weight loss can reduce apnea severity but does not cure moderate OSA, and CPAP must be continued until repeat sleep study documents resolution. Adherence is defined as more than 4 hours per night for at least 70 percent of nights, with the goal being use across the ENTIRE sleep period because apneas occur most in REM sleep late in the night. Mask hygiene and follow-up for side effects are correct.

## In-depth explanation

Common misconception: a small weight loss eliminates OSA. CPAP discontinuation requires repeat polysomnography. Reinforce that untreated OSA increases CV mortality, hypertension, and atrial fibrillation.

## Clinical scenario

AHI 22 events per hour. BMI 34. Reports daytime somnolence and witnessed apneas by spouse. Discharged with auto-titrating CPAP and nasal mask.

## Key concepts

- **obstructive sleep apnea** — Repetitive upper airway collapse during sleep causing apneas/hypopneas.
- **AHI** — Apnea-Hypopnea Index; events per hour. 5-14 mild, 15-29 moderate, 30+ severe.
- **CPAP** — Continuous positive airway pressure; pneumatic splint of the upper airway.

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