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There are sparse data on patients with OSAHS who are well treated with continuous positive airway pressures (CPAP) but continue to experience residual EDS. We sought to prospectively review a patient cohort to understand causes associated with this symptom.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with OSA and documented evidence of CPAP usage and respiratory control were recruited from a large tertiary referral centre (GSTT\/2024\/16137). Data are presented as mean (standard deviation).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Data were collected between 05\/2024 and 01\/2025. Out of 63 patients that were identified and pre-screened, we included 50 (age 56.7 (13.1) years, gender (male: female) 33:17, body mass index, BMI 36.6 (9.5) kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ). Patients had been diagnosed with OSAHS (AHI 36.7 (20.0) events x hour\n                      <jats:sup>\u2212\u20091<\/jats:sup>\n                      ; residual AHI on CPAP 4.2 (3.8) events x hour\n                      <jats:sup>\u2212\u20091<\/jats:sup>\n                      ;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), were adherent to CPAP (6.2 (1.6) hours x night\n                      <jats:sup>\u2212\u20091<\/jats:sup>\n                      ), and remained sleepy (pre-therapeutic ESS 17.6 (3.7) points; residual ESS on therapy 14.9 (4.0) points;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Common comorbidities included chronic pain (46%), Restless Legs Syndrome\/Periodic Limb Movement Disorder (34%), mental health issues (anxiety\/depression, 68%), other sleep disorders (36%), cardiovascular disease (68%), and type-2 diabetes (32%). Co-medication included analgesia (22%), antidepressants (58%), dopaminergic drugs (10%); antihypertensives (56%), antidiabetics (22%), no patient was taking benzodiazepines.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The identified cohort of patients with OSA and residual EDS still experienced a significant improvement of their symptoms with CPAP therapy. However, residual EDS may be attributable to substantial comorbidities with sleep fragmentation and co-medication.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11325-026-03655-6","type":"journal-article","created":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T13:28:39Z","timestamp":1774704519000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Residual daytime sleepiness in patients with obstructive sleep apnoea syndrome: A service review in a tertiary sleep centre"],"prefix":"10.1007","volume":"30","author":[{"given":"Jasvinder Singh","family":"Kaler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biswajit","family":"Chakrabarti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonya","family":"Craig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1587-3109","authenticated-orcid":false,"given":"Joerg","family":"Steier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,28]]},"reference":[{"issue":"8","key":"3655_CR1","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1016\/S2213-2600(19)30198-5","volume":"7","author":"AV Benjafield","year":"2019","unstructured":"Benjafield AV, Ayas NT, Eastwood PR et al (2019) Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. 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