+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Sleepiness, continuous positive airway pressure and the obstructive sleep apnea hypopnea syndrome



Sleepiness, continuous positive airway pressure and the obstructive sleep apnea hypopnea syndrome



Revue des Maladies Respiratoires 35(2): 116-133



Excessive daytime sleepiness is a major symptom in cases of the obstructive sleep apnea-hypopnea syndrome. Most often, it is vastly improved by treatment with continuous positive airway pressure (CPAP). The most effective way to confirm its disappearance is through wakefulness maintenance testing. If residual sleepiness remains, despite CPAP, further diagnostic investigation must be carried out. Firstly, it must be assessed whether the treatment is fully effective (apnea hypopnea index<10/h) by examining flow limitations under treatment (polysomnography) and whether it is sufficiently used (>6h/night). If this is the case, the possibility of other situations responsible for excessive daytime sleepiness must be reviewed and eliminated, whether they are depression, sleep insufficiency, use of intoxicants, obesity, restless legs syndrome, or circadian sleep-wake cycle disorder. If not, the multiple sleep latency tests make it possible to assess sleepiness (latency<8min) and can lead to a diagnosis of central hypersomnia (narcolepsy, idiopathic hypersomnia, hypersomnia due to a medical pathology). In some rare cases (about 6% of patients) investigations will reveal central hypersomnia due to the obstructive sleep apnea-hypopnea syndrome or "lesional" hypersomnia due to intermittent hypoxia. Since 2011, medications treating excessive sleepiness have had marketing authorization only for narcolepsy in France. However, they can be administered by way of derogation to other neurological hypersomnias on prescription by a reference centre or a centre with expertise in hypersomnia.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 065519052

Download citation: RISBibTeXText

PMID: 29454715

DOI: 10.1016/j.rmr.2017.04.005


Related references

Subjective sleepiness among patients with obstructive sleep apnea-hypopnea syndrome who were treated with a continuous positive airway pressure device. Sleep and Biological Rhythms 6(3): 155-162, 2008

Modafinil for treatment of residual excessive sleepiness in nasal continuous positive airway pressure-treated obstructive sleep apnea/hypopnea syndrome. Sleep 28(4): 464-471, 2005

Effect of adherence on daytime sleepiness, fatigue, depression and sleep quality in the obstructive sleep apnea/hypopnea syndrome patients undertaking nasal continuous positive airway pressure therapy. Patient Preference and Adherence 11: 769-779, 2017

Effect of continuous positive airway pressure treatment on the subsequent EEG spectral power and sleepiness over sustained wakefulness in patients with obstructive sleep apnea-hypopnea syndrome. Clinical Neurophysiology 122(5): 958-965, 2011

Evaluation of the apnea-hypopnea index determined by the S8 auto-CPAP, a continuous positive airway pressure device, in patients with obstructive sleep apnea-hypopnea syndrome. Journal of Clinical Sleep Medicine 6(2): 146-151, 2010

Continuous positive airway pressure probably results in fewer apnea-hypopnea episodes per hour but not in less sleepiness compared with mandibular advance devices in patients with obstructive sleep apnea. Journal of the American Dental Association 149(4): E67, 2018

Difference in continuous positive airway pressure efficiency on excessive daytime sleepiness in sleep apnea/hypopnea syndrome. European Respiratory Journal 8(Suppl. 19): 325S, 1995

Continuous positive airway pressure treatment for obstructive sleep apnea hypopnea syndrome. 2007

Continuous positive airway pressure treatment for obstructive sleep apnea hypopnea syndrome. Zhonghua Jie he He Hu Xi Za Zhi 30(12): 889-891, 2007

Therapeutic alternatives to continuous positive airway pressure for obstructive sleep apnea-hypopnea syndrome. Presse Medicale 46(4): 432-437, 2017

The effect of multilevel upper airway surgery on continuous positive airway pressure therapy in obstructive sleep apnea/hypopnea syndrome. Laryngoscope 119(1): 193-196, 2009

Comparison of different continuous positive airway pressure titration methods for obstructive sleep apnea hypopnea syndrome. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 49(10): 839-843, 2014

An economic analysis of continuous positive airway pressure for the treatment of obstructive sleep apnea-hypopnea syndrome. International Journal of Technology Assessment in Health Care 25(1): 26-34, 2009

When does 'mild' obstructive sleep apnea/hypopnea syndrome merit continuous positive airway pressure treatment?. American Journal of Respiratory and Critical Care Medicine 165(6): 743-745, 2002

Effect of continuous positive airway pressure on allergic rhinitis in patients with obstructive sleep apnea-hypopnea syndrome. Therapeutics and Clinical Risk Management 14: 1507-1513, 2018