Guidelines for the assessment and management of residual sleepiness in obstructive apnea-hypopnea syndrome : Endorsed by the French Sleep Research and Medicine Society (SFRMS) and the French Speaking Society of Respiratory Diseases (SPLF) - 11/06/24

→ Publication en français dans la revue Médecine du Sommeil en aout 2023 : https://doi.org/10.1016/j.msom.2023.06.001
Abstract |
Excessive daytime sleepiness (EDS) is frequent among patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and can persist despite the optimal correction of respiratory events (apnea, hypopnea and respiratory efforts), using continuous positive airway pressure (CPAP) or mandibular advancement device. Symptoms like apathy and fatigue may be mistaken for EDS. In addition, EDS has multi-factorial origin, which makes its evaluation complex. The marketing authorization [Autorisation de Mise sur le Marché (AMM)] for two wake-promoting agents (solriamfetol and pitolisant) raises several practical issues for clinicians. This consensus paper presents recommendations of good clinical practice to identify and evaluate EDS in this context, and to manage and follow-up the patients. It was conducted under the mandate of the French Societies for sleep medicine and for pneumology [Société Française de Recherche et de Médecine du Sommeil (SFRMS) and Société de Pneumologie de Langue Française (SPLF)]. A management algorithm is suggested, as well as a list of conditions during which the patient should be referred to a sleep center or a sleep specialist. The benefit/risk balance of a wake-promoting drug in residual EDS in OSAHS patients must be regularly reevaluated, especially in elderly patients with increased cardiovascular and psychiatric disorders risks. This consensus is based on the scientific knowledge at the time of the publication and may be revised according to their evolution.
Le texte complet de cet article est disponible en PDF.Keywords : Residual sleepiness, sleep apnea, Consensus, Recommendations, Stimulant
Abbreviations : AASM, MA, BDI, CGI-C, CV, ESS, EEG, EQ-5D, HR, FDG, FOSQ, HAD, HAS, PAH, AHI, IHSS, MRI, IRSNa, ISRS, PR, ABPM, NHP, MAD, BP, PGI-C, PHQ4, PLMS, PNDS, POMS, PPC, PSG, PSQI, RP, PVT, RERA, RDI, SAS, OSAHS, EDS, rEDS, SF36, SFRMS, SPLF, PET, MSLT, MWT, PPV
Plan
Coordination: I. Arnulf and L. Barateau. Working groups: Neurology: Arnulf, L. Barateau, C. Monaca; Pneumology: S. Baillieul, F. Gagnadoux, D. Jaffuel, M. Patout, J.L. Pépin; Psychiatry: P.A. Geoffroy, J.A. Micoulaud-Franchi, P. Philip. Validated by SFRMS scientific committee. Validated by SPLF scientific committee. Revisions and validation by: C. Andrejak (pneumologist, general secretary of the SPLF scientific board), E. Bequignon (ENT, chair of the French ENT sleep association, ASFORL), P. Boutouyrie (pharmacologist, cardiologist), Y. Dauvilliers (neurologist, coordinator of the narcolepsy hypersomnias rare reference/competence centers), D. Montani (pneumologist, pulmonary hypertension reference center), C. Pilette (pneumologist, SPLF “non-sleep expert” representative), R. Tamisier (pneumologist, chair of the SFRMS scientific board), W. Trzepizur (pneumologist, member of the SPLF scientific board). by SFRMS scientific committee. Validated by SPLF scientific committee. |
Vol 86
Article 101105- novembre 2024 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.