Investigation and management of residual sleepiness in CPAP-treated patients with obstructive sleep apnoea: the European view
Sonya Craig,Jean-Louis Pépin,Winfried Randerath,C. Causse,Johan Verbraecken,Jerryll Asin,Ferran Barbé,Maria R. Bonsignore +7 more
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TLDR
The potential prognostic significance of E DS in OSA patients at diagnosis is discussed, the prevalence and predictors of residual EDS in treated OSA Patients, and the evolution of therapy for EDS specifically for Europe are discussed.Abstract:
Excessive daytime sleepiness (EDS) is a major symptom of obstructive sleep apnoea (OSA), defined as the inability to stay awake during the day. Its clinical descriptors remain elusive, and the pathogenesis is complex, with disorders such as insufficient sleep and depression commonly associated. Subjective EDS can be evaluated using the Epworth Sleepiness Scale, in which the patient reports the probability of dozing in certain situations; however, its reliability has been challenged. Objective tests such as the multiple sleep latency test or the maintenance of wakefulness test are not commonly used in patients with OSA, since they require nocturnal polysomnography, daytime testing and are expensive. Drugs for EDS are available in the United States but were discontinued in Europe some time ago. For European respiratory physicians, treatment of EDS with medication is new and they may lack experience in pharmacological treatment of EDS, while novel wake-promoting drugs have been recently developed and approved for clinical use in OSA patients in the USA and Europe. This review will discuss 1) the potential prognostic significance of EDS in OSA patients at diagnosis, 2) the prevalence and predictors of residual EDS in treated OSA patients, and 3) the evolution of therapy for EDS specifically for Europe. Drugs for EDS are available in the USA but were discontinued in Europe some time ago. For European sleep doctors, treatment of EDS with medication is new, while novel wake-promoting drugs have been developed and approved for clinical use in OSA patients. https://bit.ly/3u9y3Lnread more
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Epidemiology, Physiology and Clinical Approach to Sleepiness at the Wheel in OSA Patients: A Narrative Review
TL;DR: A review of the epidemiological, physiological and clinical aspects of obstructive sleep apnea, with a particular focus on the methods to recognize those patients at risk of SW, is provided.
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The individual and societal prices of non-adherence to continuous positive airway pressure, contributors, and strategies for improvement
Monique Mendelson,Francois Bettega,Renaud Tamisier,Sébastien Baillieul,Sébastien Bailly,Jean-Louis Pépin +5 more
TL;DR: In this paper , the authors present the individual and societal costs of non-adherence to CPAP, factors associated with nonadherence, as well as current strategies for improving adherence including telehealth, couple-based interventions, and behavioral interventions.
References
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Journal ArticleDOI
A new method for measuring daytime sleepiness: the Epworth sleepiness scale.
TL;DR: The development and use of a new scale, the Epworth sleepiness scale (ESS), is described, which is a simple, self-administered questionnaire which is shown to provide a measurement of the subject's general level of daytime sleepiness.
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Relationship between hours of CPAP use and achieving normal levels of sleepiness and daily functioning.
Terri E. Weaver,Greg Maislin,David F. Dinges,Thomas J Bloxham,Charles F. P. George,Harly Greenberg,Gihan A Kader,Mark W. Mahowald,Joel Younger,Allan I. Pack +9 more
TL;DR: It is suggested that a greater percentage of patients will achieve normal functioning with longer nightly CPAP durations, but what constitutes adequate use varies between different outcomes.
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Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised prospective parallel trial
TL;DR: The effects of therapeutic NCPAP reduces excessive daytime sleepiness and improves self-reported health status compared with a subtherapeutic control and confirms previous uncontrolled clinical observations and the results of controlled trials that used an oral placebo.
Journal ArticleDOI
Obstructive sleep apnoea syndrome
Patrick Levy,Malcolm Kohler,Walter T. McNicholas,Ferran Barbé,R. Doug McEvoy,Virend K. Somers,Lena Lavie,Jean-Louis Pépin +7 more
TL;DR: Continuous positive airway pressure (CPAP) is the primary treatment modality in patients with severe OSAS, whereas oral appliances are also widely used in mild to moderate forms, and combining different treatment modalities such as CPAP and weight control is beneficial, but need to be evaluated in randomized controlled trials.