Long-term evolution of daytime somnolence in patients with sleep apnea/hypopnea syndrome treated by continuous positive airway pressure

• Published in: Sleep (New York, N.Y.) N.Y.), 1997-12, Vol.20 (12), p.1162-1166
• Main Authors: MEURICE, J. C, PAQUEREAU, J, NEAU, J. P, CARON, E, DORE, P, INGRAND, P, PATTE, F
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Diseases of the upper aerodigestive tract; Disorders of Excessive Somnolence - etiology; Ent and stomatology; Humans; Medical sciences; Middle Aged; Positive-Pressure Respiration - methods; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Sleep Apnea Syndromes - complications; Sleep Apnea Syndromes - therapy; Sleep Stages - physiology; Sleep, REM - physiology; Time Factors; Wakefulness
• ISSN: 0161-8105; 1550-9109; 1550-9109
• DOI: 10.1093/sleep/20.12.1162

We demonstrated in a previous study that excessive daytime sleepiness (EDS) in patients who have sleep apnea/hypopnea syndrome (SAHS) and are undergoing continuous positive airway pressure (CPAP) treatment improved differently in two groups of patients: in group I, multiple sleep latency tests (MSLT) were normalized after 50 days of treatment (individual value > 10 minutes), whereas they remained low (individual value < 10 minutes) in group II, with a significant difference between groups. To evaluate the long-term evolution of daytime somnolence under nasal CPAP treatment, five patients from group I and seven patients from group II underwent a new polysomnography and MSLT 4 years after the previous study. Clinical, polysomnographic and MSLT results obtained at baseline before treatment (T1), after the initial 50-day period of CPAP treatment (T2), and after 4 years (T3) were compared. The significant difference in mean MSLT value between the two groups previously observed at T1 and T2 disappeared at T3 (group I: 12.4+/-5.9 minutes; group II: 9.7+/-5.9 minutes). We found that this long-term improvement in excessive daytime somnolence was independent of the initial MSLT value, the severity of SAHS, and the initial MSLT changes under nasal CPAP. Long-term MSLT evolution was significantly correlated to CPAP compliance. These results demonstrate that even in the absence of a significant increase in MSLT at the beginning of CPAP treatment, further improvement is still possible several years later, which may encourage the regular, long-term use of nasal CPAP by patients.