{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T04:52:25Z","timestamp":1791175945049,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,2,15]],"date-time":"2013-02-15T00:00:00Z","timestamp":1360886400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2013,8]]},"abstract":"Summary<\/jats:title>Hypoxic brain damage might explain persistent sleepiness in some continuous positive airway pressure\u2010compliant obstructive sleep apnea called residual excessive sleepiness. Although continuous positive airway pressure may not be fully efficient in treating this symptom, wake\u2010promoting drug prescription in residual excessive sleepiness is no longer allowed by the E<\/jats:styled-content>uropean M<\/jats:styled-content>edicines A<\/jats:styled-content>gency. The aim of this study is to describe residual excessive sleepiness phenotypes in a large prospective sample of patients with obstructive sleep apnea. Residual excessive sleepiness was defined by an E<\/jats:styled-content>pworth S<\/jats:styled-content>leepiness S<\/jats:styled-content>cale score\u00a0\u2265\u00a011. Eligible patients from the F<\/jats:styled-content>rench N<\/jats:styled-content>ational S<\/jats:styled-content>leep R<\/jats:styled-content>egistry attending follow\u2010up continuous positive airway pressure visits numbered 1047. Patients using continuous positive airway pressure <\u00a03\u00a0h (n\u00a0<\/jats:italic>=\u00a0275), with residual apnea\u2013hypopnea index >\u00a015\u00a0h\u22121<\/jats:sup> (n<\/jats:italic>\u00a0=\u00a031) or with major depression were excluded (n<\/jats:italic>\u00a0=\u00a0150). Residual excessive sleepiness prevalence in continuous positive airway pressure\u2010treated obstructive sleep apnea was 13% (18% for those with an initial E<\/jats:styled-content>pworth S<\/jats:styled-content>leepiness S<\/jats:styled-content>cale score >\u00a011), and significantly decreased with continuous positive airway pressure use (9% in \u2265\u00a06\u00a0h night\u22121<\/jats:sup> continuous positive airway pressure users, P<\/jats:italic>\u00a0<\u00a00.005). At the time of diagnosis, patients with residual excessive sleepiness had worse subjective appreciation of their disease (general health scale, E<\/jats:styled-content>pworth S<\/jats:styled-content>leepiness S<\/jats:styled-content>cale and fatigue score), and complained more frequently of continuous positive airway pressure side\u2010effects. Residual excessive sleepiness prevalence was lower in severe obstructive sleep apnea than in moderate obstructive sleep apnea (11% when AHI<\/jats:styled-content> >\u00a030\u00a0h\u22121<\/jats:sup> versus 18% when AHI<\/jats:styled-content> 15\u201330, P<\/jats:italic>\u00a0<\u00a00.005). There was no relationship between residual excessive sleepiness and body mass index, cardiovascular co\u2010morbidities or diabetes. Continuous positive airway pressure improved symptoms in the whole population, but to a lower extent in patients with residual excessive sleepiness (fatigue scale: \u22125.2 versus \u22122.7 in residual excessive sleepiness\u2212 and residual excessive sleepiness+ patients, respectively, P<\/jats:italic>\u00a0<\u00a00.001). Residual excessive sleepiness prevalence decreased with continuous positive airway pressure compliance. Hypoxic insult is unlikely to explain residual excessive sleepiness as obstructive sleep apnea severity does not seem to be critical. Residual symptoms are not limited to sleepiness, suggesting a true \u2018continuous positive airway pressure\u2010resistant syndrome\u2019, which may justify treatment by wake\u2010promoting drugs.<\/jats:p>","DOI":"10.1111\/jsr.12039","type":"journal-article","created":{"date-parts":[[2013,2,15]],"date-time":"2013-02-15T08:08:46Z","timestamp":1360915726000},"page":"389-397","source":"Crossref","is-referenced-by-count":196,"title":["Residual sleepiness in sleep apnea patients treated by continuous positive airway pressure"],"prefix":"10.1111","volume":"22","author":[{"given":"Merce","family":"Gasa","sequence":"first","affiliation":[{"name":"INSERM U 1042, Joseph Fourier University HP2 Laboratory (Hypoxia: Pathophysiology) La Tronche France"},{"name":"Sleep Unit, Department of Respiratory Medicine Hospital Universitari de Bellvitge and Bellvitge Biomedical Research Institute (IDIBELL) Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renaud","family":"Tamisier","sequence":"additional","affiliation":[{"name":"INSERM U 1042, Joseph Fourier University HP2 Laboratory (Hypoxia: Pathophysiology) La Tronche France"},{"name":"Sleep Laboratory and EFCR, Locomotion, Rehabilitation and Physiology Department Grenoble University Hospital Grenoble CEDEX 09 France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandrine H.","family":"Launois","sequence":"additional","affiliation":[{"name":"INSERM U 1042, Joseph Fourier University HP2 Laboratory (Hypoxia: Pathophysiology) La Tronche France"},{"name":"Sleep Laboratory and EFCR, Locomotion, Rehabilitation and Physiology Department Grenoble University Hospital Grenoble CEDEX 09 France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Sapene","sequence":"additional","affiliation":[{"name":"Unit\u00e9 Sommeil et Vigilance Polyclinique Bordeaux Cauderan Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Martin","sequence":"additional","affiliation":[{"name":"Unit\u00e9 des pathologies du sommeil Centre hospitalier de Compi\u00e8gne Compiegne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Stach","sequence":"additional","affiliation":[{"name":"Service de pneumologie Clinique Teissier Valenciennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"Grillet","sequence":"additional","affiliation":[{"name":"Pneumologie Cabinet priv\u00e9 Valence France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Levy","sequence":"additional","affiliation":[{"name":"INSERM U 1042, Joseph Fourier University HP2 Laboratory (Hypoxia: Pathophysiology) La Tronche France"},{"name":"Sleep Laboratory and EFCR, Locomotion, Rehabilitation and Physiology Department Grenoble University Hospital Grenoble CEDEX 09 France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Louis","family":"Pepin","sequence":"additional","affiliation":[{"name":"INSERM U 1042, Joseph Fourier University HP2 Laboratory (Hypoxia: Pathophysiology) La Tronche France"},{"name":"Sleep Laboratory and EFCR, Locomotion, Rehabilitation and Physiology Department Grenoble University Hospital Grenoble CEDEX 09 France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,2,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.04.00127603"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/34.1.111"},{"key":"e_1_2_9_4_1","first-page":"CD001106","article-title":"Continuous positive airways pressure for obstructive sleep apnea in adults","volume":"25","author":"Giles T. 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