Pépin J-L, Viot-Blanc V, Escourrou P, Racineux J-L, Sapene M, Lévy P, Dervaux B, Lenne X, Mallart A
HP2 Laboratory (Hypoxia Pathophysiology), INSERM ERI 0017, EA 3745 Joseph Fourier University, Grenoble, France.
Eur Respir J. 2009 May;33(5):1062-7. doi: 10.1183/09031936.00016808.
The percentage of compliant continuous positive airway pressure (CPAP)-treated apnoeic patients that continue to experience residual excessive sleepiness (RES) is unknown. RES was defined by an Epworth Sleepiness Scale (ESS) score of >or=11. In total, 502 patients from 37 French sleep centres using CPAP >3 h night(-1) attending their 1-yr follow-up visit were eligible. ESS and polysomnographic data as well as symptoms, quality of life, depression scores and objective CPAP compliance at 1 yr were collected. Overall, 60 patients remained sleepy on CPAP (ESS 14.3+/-2.5) leading to a prevalence rate of RES of 12.0% (95% confidence interval (CI) 9.1-14.8). After having excluded associated restless leg syndrome, major depressive disorder and narcolepsy as confounding causes, the final prevalence rate of RES was 6.0% (95% CI 3.9-8.01). Patients with RES were younger and more sleepy at diagnosis. The relative risk of having RES was 5.3 (95% CI 1.6-22.1), when ESS before treatment was >or=11. Scores of emotional and energy Nottingham Health Profile domains were two times worse in patients with RES. As 230,000 obstructive sleep apnoea patients are currently treated in France by continuous positive airway pressure, more than 13,800 of them might suffer from residual excessive sleepiness.
持续气道正压通气（CPAP）治疗的呼吸暂停患者中，仍有残余过度嗜睡（RES）症状的患者比例尚不清楚。RES的定义为Epworth嗜睡量表（ESS）得分≥11分。共有来自法国37个睡眠中心、每晚使用CPAP超过3小时且前来进行1年随访的502例患者符合条件。收集了ESS、多导睡眠图数据以及1年时的症状、生活质量、抑郁评分和客观CPAP依从性。总体而言，60例患者使用CPAP后仍感困倦（ESS为14.3±2.5），RES患病率为12.0%（95%置信区间[CI] 9.1 - 14.8）。在排除不安腿综合征、重度抑郁症和发作性睡病等混杂因素后，RES最终患病率为6.0%（95% CI 3.9 - 8.01）。RES患者在诊断时更年轻且嗜睡程度更高。治疗前ESS≥11分时，出现RES的相对风险为5.3（95% CI 1.6 - 22.1）。RES患者的情绪和精力诺丁汉健康量表领域得分比其他人差两倍。由于目前法国有23万阻塞性睡眠呼吸暂停患者接受持续气道正压通气治疗，其中超过13800人可能患有残余过度嗜睡。
