In a patient being assessed before gastric bypass surgery with a BMI of 36 and an AHI of 40, what is the recommended action for their immediate post-operative treatment plan regarding CPAP therapy?

Continuing the current CPAP therapy is the recommended action for the immediate post-operative treatment plan in this scenario. For a patient with obesity and a significant apnea-hypopnea index (AHI) of 40, maintaining their current CPAP settings post-operatively is crucial to ensure effective management of obstructive sleep apnea (OSA).

During the post-operative period, especially following a surgical procedure such as gastric bypass, patients may experience changes in their respiratory function due to anesthesia, pain, or positioning. However, if the patient has been stable on their current CPAP settings prior to surgery, it is generally advisable to stick with these settings until a thorough assessment can be performed post-surgery. This continuity helps in mitigating the risk of apnea events and other respiratory complications that may arise in the immediate recovery phase.

While increasing CPAP or switching to auto-PAP therapy could be considered if the patient showed signs of worsening OSA symptoms post-operatively, such adjustments should only be made based on objective assessment, which is not typically feasible immediately after surgery. The use of supplemental oxygen, although beneficial in certain cases, does not address the underlying problem of obstructive sleep apnea directly and should not replace CPAP therapy in patients who are dependent on it.