title: Residual sleepiness in obstructive sleep apnoea: phenotype and related symptoms.
abstract: The characteristics of residual excessive sleepiness (RES), defined by an Epworth score >10 in adequately treated apnoeic patients, are unknown. 40 apnoeic patients, with (n = 20) and without (n = 20) RES, and 20 healthy controls underwent clinical interviews, cognitive and biological tests, polysomnography, a multiple sleep latency test, and 24-h sleep monitoring. The marked subjective sleepiness in the RES group (mean ± sd score 16.4 ± 3) contrasted with moderately abnormal objective measures of sleepiness (90% of patients with RES had daytime sleep latencies >8 min). Compared with patients without RES, the patients with RES had more fatigue, lower stage N3 percentages, more periodic leg movements (without arousals), lower mean sleep latencies and longer daytime sleep periods. Most neuropsychological dimensions (morning headaches, memory complaints, spatial memory, inattention, apathy, depression, anxiety and lack of self-confidence) were not different between patients with and without RES, but gradually altered from controls to apnoeic patients without and then with RES. RES in apnoeic patients differs markedly from sleepiness in central hypersomnia. The association between RES, periodic leg movements, apathy and depressive mood parallels the post-hypoxic lesions in noradrenaline, dopamine and serotonin systems in animals exposed to intermittent hypoxia.
authors.affiliation: Sleep Disorders Unit, UMR 975, National Reference Centre for Narcolepsy and Hypersomnia, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Vernet
authors.forename: S
authors.initials: S
authors.lastname: Redolfi
authors.forename: V
authors.initials: V
authors.lastname: Attali
authors.forename: E
authors.initials: E
authors.lastname: Konofal
authors.forename: A
authors.initials: A
authors.lastname: Brion
authors.forename: E
authors.initials: E
authors.lastname: Frija-Orvoen
authors.forename: M
authors.initials: M
authors.lastname: Pottier
authors.forename: T
authors.initials: T
authors.lastname: Similowski
authors.forename: I
authors.initials: I
authors.lastname: Arnulf
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis*; D005221:Fatigue; D005260:Female; D005602:France; D006801:Humans; D000860:Hypoxia; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D017286:Polysomnography; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*; D012894:Sleep Stages; D013997:Time Factors