title: Residual Daytime Sleepiness in Obstructive Sleep Apnea After Continuous Positive Airway Pressure Optimization: Causes and Management.
abstract: 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.
authors.affiliation: NeuroSleep Centre of Research Excellence, Woolcock Institute of Medical Research, Sleep and Circadian Research Group, University of Sydney, Glebe Point Road, Glebe, Sydney, New South Wales 2050, Australia; Respiratory and Sleep Department, Royal Prince Alfred Hospital, Sydney Local Health District, Missenden Road, Camperdown, Sydney, New South Wales 2050, Australia. Electronic address: Julia.chapman@sydney.edu.au.
authors.forename: Julia L
authors.initials: JL
authors.lastname: Chapman
authors.affiliation: NeuroSleep Centre of Research Excellence, Woolcock Institute of Medical Research, Sleep and Circadian Research Group, University of Sydney, Glebe Point Road, Glebe, Sydney, New South Wales 2050, Australia.
authors.forename: Yasmina
authors.initials: Y
authors.lastname: Serinel
authors.affiliation: Sydney Nursing School, The University of Sydney, M02, Sydney, New South Wales 2006, Australia.
authors.forename: Nathaniel S
authors.initials: NS
authors.lastname: Marshall
authors.affiliation: NeuroSleep Centre of Research Excellence, Woolcock Institute of Medical Research, Sleep and Circadian Research Group, University of Sydney, Glebe Point Road, Glebe, Sydney, New South Wales 2050, Australia; Respiratory and Sleep Department, Royal Prince Alfred Hospital, Sydney Local Health District, Missenden Road, Camperdown, Sydney, New South Wales 2050, Australia.
authors.forename: Ronald R
authors.initials: RR
authors.lastname: Grunstein
mesh_terms: D045422:Continuous Positive Airway Pressure / Q000379:methods*; D006970:Disorders of Excessive Somnolence / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000628:therapy*; D064690:Wakefulness-Promoting Agents / Q000627:therapeutic use*
chemical_list: D064690:Wakefulness-Promoting Agents
keywords: Armodafinil; CPAP; Comorbid conditions; Excessive daytime sleepiness; Modafinil; Sleep disorders; Wakefulness promoters