Which sleep disorder is most consistently treated with CPAP as a cornerstone therapy?

• A. Narcolepsy
• B. Insomnia
• C. Obstructive Sleep Apnea
• D. REM sleep behavior disorder

Answer: (B)

Continuous positive airway pressure (CPAP) is the cornerstone therapy for obstructive sleep apnea because the core problem in this condition is repeated airway collapse during sleep. The airway relaxes and narrows or closes, causing breathing pauses, drops in oxygen, and disrupted sleep. CPAP delivers a steady stream of air that acts like a splint to keep the upper airway open throughout the night, preventing these events. With fewer apneas and hypopneas, oxygen improves, sleep becomes more restful, and daytime sleepiness decreases. This strong, direct address of the underlying mechanism is why CPAP is the first-line treatment for obstructive sleep apnea in most adults and is considered the mainstay of therapy.

The other disorders involve different problems and are managed with different approaches. Narcolepsy is treated with wake-promoting agents and structured daytime napping; insomnia is typically approached with cognitive behavioral therapy for insomnia (CBT-I) and sleep hygiene, with medications used selectively and short-term; REM sleep behavior disorder is usually treated with melatonin or clonazepam to reduce dream enactment rather than airway management.