Residual respiratory events and daytime sleepiness despite management of obstructive sleep apnoea with and without additional central apnoeas. A three-month follow-up study.

Abstract

Despite treatment, individuals with obstructive sleep apnoea (OSA) may still exhibit high apnoea and hypopnoea indices (AHI) and excessive daytime sleepiness (EDS). We recorded residual respiratory events (rAHI≥ 10) and EDS (rEDS) (Epworth Sleepiness Scale [ESS]≥ 10) at three months after participants had been adapted to nighttime ventilatory therapy. A retrospective analysis was performed on data recorded over ten years of cardiorespiratory monitoring (CRM) at a three-month follow-up of night therapy. The prevalence of respiratory events and/or EDS was assessed. Professional activities were also recorded. 726 OSA individuals were included. The baseline prevalences of group 1: without rAHI (AHI≤ 10) + without rEDS (ESS≤ 10); group 2: with rAHI (> 10) + without rEDS; group 3: without rAHI + with rEDS (ESS> 10) and group 4: with rAHI + with rEDS were 3.4 %, 57.3 %, 1.7 %, and 37.6 %, respectively. After adaptation to night therapy, these percentages changed to 79.1 %, 10.6 %, 7.3 %, and 3.0 %, respectively. Individuals with rAHI and/or rEDS were older with more comorbidities, central apnoeas, and higher baseline ESS as compared to those without. The most frequent actions were device resetting, unscheduled visits, scheduled follow-up visits, and SpO₂ monitoring. The present study supports the use of an outpatient adaptation/titration and monitoring protocol for OSA patients, despite the requirement of close monitoring, particularly in those with central apneas or EDS at baseline.