Open Access
CC BY-NC-ND 4.0 · Sleep Sci 2024; 17(S 01): S1-S89
DOI: 10.1055/s-0045-1811910
Sleep Science Supplement 2024

Multidisciplinary Approach to Residual Daytime Sleepiness in Obstructive Sleep Apnea: A Case Report

Autoren

  • Damacio Soares Paiva

    1   Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil

  • Enrique Marcelino Neves

    1   Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil

  • Rayane Bezerra Freitas

    1   Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil

  • Maria Luisa Nobre

    1   Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil

  • Katie Almondes

    1   Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
Weitere Informationen
Auch verfügbar auf
 
 

Keywords

sleep disorders - hypersomnolence - sleep quality - multidisciplinarity - sleep pattern

Introduction: Excessive Daytime Sleepiness (EDS) represents relevant impairment in the patient's daily life. Frequently associated with a variety of sleep disorders and dysfunctional habits, such as poor sleep hygiene, sleep deprivation, and obstructive sleep apnea (OSA), leading to disrupted sleep and reduced oxygen saturation. In this report, we present the case of a 53-year-old female patient with a history of EDS and OSA, who despite adherence to Positive Airway Pressure (PAP) therapy, continues to experience debilitating daytime somnolence. This case highlights the challenges in managing EDS in patients with OSA, particularly when the standard therapy fails to reduce sleepiness.

Objective: To demonstrate the importance of a multidisciplinary approach to residual daytime sleepiness in obstructive sleep apnea.

Methods: Anamnesis, physical examination, psychological assessment, and polysomnography were performed.

Results: Despite the effective reduction of snoring through regular PAP therapy, the patient continued to experience significant daytime somnolence, affecting her quality of life (Epworth Sleepiness Scale score: 14). A thorough examination by otorhinolaryngology revealed no major abnormalities except for a minor deviated nasal septum. Physiotherapy evaluations led to adjustments in PAP settings, although compliance was suboptimal. A further sleep study indicated an apnea-hypopnea index of 16.6/h with a minimum saturation of 75%. The multiple sleep latency test showed no sleep-onset REM periods. Psychological assessment uncovered irregular sleep patterns, including voluntary early morning awakenings for behavioral reasons, leading to worsening sleepiness and non-adherence to PAP therapy.

Conclusion: To effectively manage persistent EDS despite optimal PAP therapy, a personalized treatment plan developed by a multidisciplinary team is crucial. Addressing specific lifestyle factors and understanding the patient's sleep patterns and poor sleep habits are essential for successful therapeutic outcomes.


Die Autoren geben an, dass kein Interessenkonflikt besteht.

Publikationsverlauf

Artikel online veröffentlicht:
16. September 2025

© 2025. Brazilian Sleep Academy. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil