Subjective sleepiness among patients with obstructive sleep apnea-hypopnea syndrome who were treated with a continuous positive airway pressure device

It has been reported that continuous positive airway pressure (CPAP) improves daytime sleepiness in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). However, in some patients, the Epworth sleepiness scale (ESS) score is high even on CPAP. We assessed the prevalence, quality of life (QOL), and other factors related to subjective sleepiness among Japanese patients with OSAHS who were treated with CPAP. Data regarding the patients’ characteristics, ESS score, QOL using the MOS 36-item short-form health survey, symptoms or problems, and CPAP-related factors, including CPAP compliance, were collected. The patients were divided into two groups according to their ESS score (≥11 or <11). Overall, 484 patients were assessed, of whom 108 (22.3%) had subjective sleepiness on CPAP. Patients with subjective sleepiness on CPAP had a lower score on several SF-36 subscales. On multivariate logistic analysis regression, shorter sleeping time (odds ratio [OR] 0.67 [0.53–0.85]), presence of mask-related problems (OR 1.96 [1.24–3.11]), and poor compliance (OR 1.68 [1.01–2.63]) were significantly associated with subjective sleepiness on CPAP. In conclusion, the prevalence of subjective sleepiness on CPAP among Japanese OSAHS patients was determined. Such patients had an impaired QOL. As significant associations between several factors and such sleepiness were found, these factors should be addressed in such patients.