Residual Excessive Daytime Sleepiness in CPAP-Treated Patients: Paula K. Schweitzer, PhD


The director of research at St. Luke’s Sleep Medicine and Research Center detailed the reasons for residual excessive daytime sleepiness and the lack of literature on the topic.

"Sometimes patients with depression feel sleepy during the daytime. If the depression is inadequately treated, you may want to treat that. But sometimes it persists despite everything and sometimes the patient can’t always optimize treatment for all these conditions for whatever reason.”

An analysis conducted by Paula K. Schweitzer, PhD, and her colleagues evaluated the efficacy of solriamfetol (Sunosi; Jazz Pharmaceuticals), an FDA-approved treatment for excessive daytime sleepiness (EDS), in subgroups of participant with obstructive sleep apnea (OSA) who were adherent or nonadherent to primary OSA therapy. The investigators noted that therapy with continuous positive airway pressure (CPAP) and oral appliances has improved EDS in some patients, particularly those who are adherent to therapy, but that even patients who use their OSA therapy in an adherent manner (>6 hours/night), residual EDS may occur.

Previous reports have shown 9% to 22% of CPAP-treated patients have residual EDS, but that the underlying mechanisms are unclear. Schweitzer, director of researcher at St Luke’s Sleep Medicine and Research Center, claims that there are a number of reasons a patient can be experiencing sleepiness, including inadequate treatment and other controlled factors like insufficient sleep.

NeurologyLive sat down with Schweitzer to get her thoughts on what is currently known about residual EDS as well as what clinicians should continue to key in on in the future. She also stresses the importance of continuing to research these aspects, especially by getting a closer look at the brain.

Schweitzer PK, Strohl KP, Mayer G, et al. Effects of solriamfetol in a long-term trial of participants with obstructive sleep apnea who are adherent or nonadherent to airway therapy. J Clin Sleep Med. Published online February 1, 2021. doi: 10.5664/jcsm.8992
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