Excessive daytime sleepiness (EDS) is commonly associated with obstructive sleep apnea (OSA), which is the most common sleep disorder. EDS is a major facet of OSA that can persist despite patients receiving adequate treatment for their OSA. Currently available treatments for OSA, including continuous positive airway pressure (CPAP) and oral appliances, are often underused or rejected by patients. There are several reasons for this such as insurance coverage, discomfort, inconvenience, as well as perceived efficacy. A review by Léger and Stepnowsky (2020) found demonstrated rates of EDS in OSA of 12%-65% using the most commonly reported definition of EDS (Epworth Sleepiness Scale ≥11), and a prevalence of persistent EDS in OSA following continuous positive airway pressure treatment of 12%-65%. EDS manifests in multiple ways with adverse behavioral health outcomes, such as the serious safety issue of falling asleep while driving. There is a 2-3-fold increase in risk for patients with OSA experiencing a driving accident. Thus, EDS in OSA has a significant negative impact on quality of life, increasing socio-economic burden and damaging public health.
In your experience, what are the critical unmet needs associated with excessive daytime sleepiness and obstructive sleep apnea?
1. Leger, Damien, and Carl Stepnowsky. "The economic and societal burden of excessive daytime sleepiness in patients with obstructive sleep apnea." Sleep medicine reviews (2020): 101275.
Trial of modanifil , amphetamines, life style modification, weight loss should be considered
Trial of modanifil , amphetamines, life style modification, weight loss should be considered
Trial of modanifil , amphetamines, life style modification, weight loss should be considered
OSA , medications, obesity, drug or alcohol use, circadian rhythms and sleep patterns and comorbid medical conditions all need to be considered .
If a patient is willing to have a sleep study and is able to navigate the necessary steps such as having it completed during the pandemic and insurance issues and OSA is diagnosed,
then tolerability of CPAP can become problematic.
CPAP masks, nasal cannula, sanitation issues and insurance coverage can present as barriers to effective treatment. Seeing a doctor for follow-up with EDS and adjustments to CPAP and again insurance issues continue. Efficacy and tolerability all impact complance.
The incidence of EDS therefore can still be high.
Modafanil and other similar medications can improve EDS. Amphetamines at times with appropriate consideration is another option for treatment of EDS.
Overall the effective treatment continues to be problematic largely based on the barriers encountered.
OSA , medications, obesity, drug or alcohol use, circadian rhythms and sleep patterns and comorbid medical conditions all need to be considered .
If a patient is willing to have a sleep study and is able to navigate the necessary steps such as having it completed during the pandemic and insurance issues and OSA is diagnosed,
then tolerability of CPAP can become problematic.
CPAP masks, nasal cannula, sanitation issues and insurance coverage can present as barriers to effective treatment. Seeing a doctor for follow-up with EDS and adjustments to CPAP and again insurance issues continue. Efficacy and tolerability all impact complance.
The incidence of EDS therefore can still be high.
Modafanil and other similar medications can improve EDS. Amphetamines at times with appropriate consideration is another option for treatment of EDS.
Overall the effective treatment continues to be problematic largely based on the barriers encountered.
OSA , medications, obesity, drug or alcohol use, circadian rhythms and sleep patterns and comorbid medical conditions all need to be considered .
If a patient is willing to have a sleep study and is able to navigate the necessary steps such as having it completed during the pandemic and insurance issues and OSA is diagnosed,
then tolerability of CPAP can become problematic.
CPAP masks, nasal cannula, sanitation issues and insurance coverage can present as barriers to effective treatment. Seeing a doctor for follow-up with EDS and adjustments to CPAP and again insurance issues continue. Efficacy and tolerability all impact complance.
The incidence of EDS therefore can still be high.
Modafanil and other similar medications can improve EDS. Amphetamines at times with appropriate consideration is another option for treatment of EDS.
Overall the effective treatment continues to be problematic largely based on the barriers encountered.