A 40-year-old obese man reports excessive daytime sleepiness, loud snoring, and his wife reports witnessed apneas. Polysomnography shows an apnea-hypopnea index (AHI) of 22 events/hour. What is this threshold consistent with?

• A Mild OSA (AHI 5–14)
• B Moderate OSA (AHI 15–29) ✓
• C Severe OSA (AHI ≥30)
• D Upper airway resistance syndrome (AHI <5)

Explanation

Obstructive Sleep Apnea (OSA) severity is classified by the Apnea-Hypopnea Index (AHI): mild = 5–14 events/hour, moderate = 15–29 events/hour, severe = ≥30 events/hour. This patient's AHI of 22 falls in the moderate OSA range. CPAP (continuous positive airway pressure) is the first-line treatment for moderate-to-severe OSA and for mild OSA with symptoms. The diagnosis requires AHI ≥5 with symptoms, or AHI ≥15 even without symptoms.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

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