Residual sleepiness in sleep apnea patients treated by continuous positive airway pressure

• Published in: Journal of sleep research 2013-08, Vol.22 (4), p.389-397
• Main Authors: Gasa, Merce, Tamisier, Renaud, Launois, Sandrine H., Sapene, Marc, Martin, Francis, Stach, Bruno, Grillet, Yves, Levy, Patrick, Pepin, Jean‐Louis
• Format: Article
• Language: English
• Subjects: Body Mass Index; Comorbidity; Continuous Positive Airway Pressure; depression; Disorders of Excessive Somnolence - complications; Disorders of Excessive Somnolence - epidemiology; Disorders of Excessive Somnolence - physiopathology; Disorders of Excessive Somnolence - therapy; Fatigue - physiopathology; Female; France - epidemiology; Humans; Male; Middle Aged; Patient Compliance; Prevalence; Prospective Studies; Registries; residual excessive sleepiness; sleep apnea; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - epidemiology; Sleep Apnea, Obstructive - physiopathology; Sleep Apnea, Obstructive - therapy; Sleep Stages - physiology; Syndrome
• ISSN: 0962-1105; 1365-2869
• DOI: 10.1111/jsr.12039

Summary Hypoxic brain damage might explain persistent sleepiness in some continuous positive airway pressure‐compliant obstructive sleep apnea called residual excessive sleepiness. Although continuous positive airway pressure may not be fully efficient in treating this symptom, wake‐promoting drug prescription in residual excessive sleepiness is no longer allowed by the European Medicines Agency. The aim of this study is to describe residual excessive sleepiness phenotypes in a large prospective sample of patients with obstructive sleep apnea. Residual excessive sleepiness was defined by an Epworth Sleepiness Scale score ≥ 11. Eligible patients from the French National Sleep Registry attending follow‐up continuous positive airway pressure visits numbered 1047. Patients using continuous positive airway pressure  15 h−1 (n = 31) or with major depression were excluded (n = 150). Residual excessive sleepiness prevalence in continuous positive airway pressure‐treated obstructive sleep apnea was 13% (18% for those with an initial Epworth Sleepiness Scale score > 11), and significantly decreased with continuous positive airway pressure use (9% in ≥ 6 h night−1 continuous positive airway pressure users, P  30 h−1 versus 18% when AHI 15–30, P