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Prevalence of residual excessive sleepiness in CPAP-treated sleep apnoea patients: the French multicentre study

¹ HP2 Laboratory (Hypoxia Pathophysiology), INSERM ERI 0017, EA 3745 Joseph Fourier University, ² Sleep Laboratory, Exploration Fonctionelle Cardio Respiratoire (EFCR), University Hospital, Grenoble, ³ Sleep Unit, CHU Lariboisière, Paris, ⁴ Cephalon, Maisons-Alfort, ⁵ Service d'Exploration Fonctionnelle, Hôpital Antoine Béclère, Clamart, ⁶ Laboratoire d' Exploration Fonctionelle Respiratoire et de Sommeil, CHU d'Angers, Angers, ⁷ Unité Sommeil et Vigilance, Polyclinique, Bordeaux-Cauderan, ⁸ CRESGE, and ⁹ CHU Lille, Lille, France.

CORRESPONDENCE: J-L. Pépin, EFCR et Laboratoire du Sommeil, Pole Rééducation et Physiologie, INSERM ERI 17, CHU de Grenoble, BP 217 - 38043, Grenoble Cedex 09, France. Fax: 33 476765586. E-mail: JPepin{at}chu-grenoble.fr

Keywords: Continuous positive airway pressure, modafinil, prevalence, residual excessive sleepiness, sleep apnoea

Received: February 4, 2008
Accepted February 2, 2009

The percentage of compliant continuous positive airway pressure (CPAP)-treated apnoeic patients that continue to experience residual excessive sleepiness (RES) is unknown.

RES was defined by an Epworth Sleepiness Scale (ESS) score of 11. In total, 502 patients from 37 French sleep centres using CPAP >3 h·night^–1 attending their 1-yr follow-up visit were eligible.

ESS and polysomnographic data as well as symptoms, quality of life, depression scores and objective CPAP compliance at 1 yr were collected. Overall, 60 patients remained sleepy on CPAP (ESS 14.3±2.5) leading to a prevalence rate of RES of 12.0% (95% confidence interval (CI) 9.1–14.8). After having excluded associated restless leg syndrome, major depressive disorder and narcolepsy as confounding causes, the final prevalence rate of RES was 6.0% (95% CI 3.9–8.01). Patients with RES were younger and more sleepy at diagnosis. The relative risk of having RES was 5.3 (95% CI 1.6–22.1), when ESS before treatment was 11. Scores of emotional and energy Nottingham Health Profile domains were two times worse in patients with RES.

As 230,000 obstructive sleep apnoea patients are currently treated in France by continuous positive airway pressure, more than 13,800 of them might suffer from residual excessive sleepiness.

This article has been cited by other articles:

				J. R. Stradling Residual sleepiness in patients with OSA on CPAP Eur. Respir. J., November 1, 2009; 34(5): 1209 - 1209. [Full Text] [PDF]