Residual Daytime Sleepiness in Obstructive Sleep Apnea After Continuous Positive Airway Pressure Optimization: Causes and Management

• Published in: Sleep medicine clinics Vol. 11; no. 3; pp. 353 - 363
• Main Authors: Chapman, Julia L, Serinel, Yasmina, Marshall, Nathaniel S, Grunstein, Ronald R
• Format: Journal Article
• Language: English
• Published: United States 01-09-2016
• Subjects: Continuous Positive Airway Pressure - methods; Disorders of Excessive Somnolence - drug therapy; Disorders of Excessive Somnolence - etiology; Humans; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - therapy; Wakefulness-Promoting Agents - therapeutic use; Armodafinil; Sleep disorders; CPAP; Modafinil; Excessive daytime sleepiness; Comorbid conditions; Wakefulness promoters
• ISSN: 1556-4088
• DOI: 10.1016/j.jsmc.2016.05.005

Excessive daytime sleepiness (EDS) is common in obstructive sleep apnea (OSA), but it is also common in the general population. When sleepiness remains after continuous positive airway pressure (CPAP) treatment of OSA, comorbid conditions or permanent brain injury before CPAP therapy may be the cause of the residual sleepiness. There is currently no broad approach to treating residual EDS in patients with OSA. Individual assessment must be made of comorbid conditions and medications, and of lifestyle factors that may be contributing to the sleepiness. Modafinil and armodafinil are the only pharmacologic agents indicated for residual sleepiness in these patients.