Current Management of Residual Excessive Daytime Sleepiness Due to Obstructive Sleep Apnea: Insights for Optimizing Patient Outcomes

Abstract

Although excessive daytime sleepiness (EDS) attributable to obstructive sleep apnea (OSA) can be resolved by consistent usage of and effective treatment (often with the use of continuous positive airway pressure therapy), 12–58% of patients report residual EDS (REDS). While REDS is difficult to treat, a proportion of cases are possibly due to reversible issues, and wake-promoting medications can prove useful for the remaining cases. Given the challenges associated with effective management of REDS and its relationship to multiple comorbidities, multidisciplinary management of patients with REDS is often recommended. Here we aim to bridge the knowledge gap on the burden, risk factors, prevalence, and potential pathophysiologic mechanisms of REDS in patients with OSA after first-line treatment. The roles of primary care physicians and sleep specialists, as well as the importance of the use of objective assessment tools for the evaluation of REDS and the effective management of comorbidities, are discussed. An update of approved treatments and emerging candidate treatments is also presented.

Long-Term Efficacy and Safety of Pitolisant for Residual Sleepiness Due to OSA

“…Residual sleepiness is associated with a constellation of multidimensional symptoms (eg, fatigue, depression), altering quality of life and the patient's overall perception of good health. 7,20 In the current study, significant and sustained improvements were also demonstrated for a vigilance test (OsLer) and for functional status (fatigue, quality of life, and the physician's global assessment scales).…”

Association between poor sleep quality and an increased risk of dry eye disease in patients with obstructive sleep apnea syndrome

“…Mounting evidence demonstrates that sleep disorders are becoming prevalent health issues worldwide, with an estimate of 150 million people suffering from them ( 9 ). OSA is one of the most detected sleep disorders causing excessive daytime sleepiness along with other potential sleep disorders ( 10 ). Yet, about 80% of moderate and severe OSA cases remain undiagnosed ( 11 ).…”

Obstruktive Schlafapnoe – Einfluss auf kardiovaskuläres System und Kognition

“…The morphologically detectable changes are partially reversible by successful PAP therapy 66 121 122 123 . The irreversible morphologic brain changes are associated with residual daytime sleepiness despite adequate therapy 64 78 124 .…”

“…Die morphologisch nachweisbaren Veränderungen sind teilweise durch eine erfolgreiche PAP-Therapie reversibel 66 121 122 123 . Die irreversiblen morphologischen Hirnveränderungen werden mit einer residuellen Tagesschläfrigkeit trotz ausreichender Therapie in Verbindung gebracht 64 78 124 .…”