Search

Study objectiveExcessive daytime sleepiness is common with obstructive sleep apnoea and can persist despite efforts to optimise primary airway therapy. The literature lacks recommendations regarding differential diagnosis and management of excessive daytime sleepiness in obstructive sleep apnoea. This study sought to develop expert consensus statements to bridge the gap between existing literature/guidelines and clinical practice.MethodsA panel of 10 international experts was convened to undertake a modified Delphi process. Statements were developed based on available evidence identified through a scoping literature review, and expert opinion. Consensus was achieved through 3 rounds of iterative, blinded survey voting and revision to statements until a predetermined level of agreement was met (≥80 % voting "strongly agree" or "agree with reservation").ResultsConsensus was achieved for 32 final statements. The panel agreed excessive daytime sleepiness is a patient-reported symptom. The importance of subjective/objective evaluation of excessive daytime sleepiness in the initial evaluation and serial management of obstructive sleep apnoea was recognised. The differential diagnosis of residual excessive daytime sleepiness in obstructive sleep apnoea was discussed. Optimizing airway therapy (eg, troubleshooting issues affecting effectiveness) was addressed. The panel recognised occurrence of residual excessive daytime sleepiness in obstructive sleep apnoea despite optimal airway therapy and the need to evaluate patients for underlying causes.ConclusionsExcessive daytime sleepiness in patients with obstructive sleep apnoea is a public health issue requiring increased awareness, recognition, and attention. Implementation of these statements may improve patient care, long-term management, and clinical outcomes in patients with obstructive sleep apnoea.

This article, published in the journal Thorax, explores the effects of non-invasive ventilation (NIV) on sleep in chronic hypercapnic respiratory failure. It discusses the impact of chronic respiratory diseases on sleep quality and the potential role of NIV in improving health-related quality of life. The article also highlights the physiological changes that occur during sleep in patients with conditions such as chronic obstructive pulmonary disease (COPD), obesity-related respiratory failure (ORRF), and neuromuscular disorders (NMD). It emphasizes the importance of monitoring sleep quality in patients using long-term NIV and the need for further research to fully understand the effects of NIV on sleep quality. The document provides a list of references that cover studies on the relationship between sleep quality and various respiratory conditions, including COPD, obesity-related hypoventilation syndrome, and neuromuscular diseases. These references offer valuable information for researchers and healthcare professionals working with these patient populations. [Extracted from the article]