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Sleep Med Clin. 2017 Sep;12(3):369-382. doi: 10.1016/j.jsmc.2017.03.010. Epub 2017 May 19.

Sleep-Disordered Breathing and Excessive Daytime Sleepiness.

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Division of General Internal Medicine, University of Washington, Seattle, WA 98195, USA; Hospital and Sleep Medicine Sections, VA Puget Sound Health Care System, S-111-Pulm, 1660 South Columbian Way, Seattle, WA 98108, USA.
Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA 98104, USA.


Sleep-related breathing disorders include obstructive sleep apnea (OSA), central sleep apnea, sleep-related hypoventilation, and sleep-related hypoxemia. Excessive daytime sleepiness (EDS) is frequently reported by patients with OSA but is not invariably present. The efficacy of positive airway pressure therapy in improving EDS is well established for OSA, but effectiveness is limited by suboptimal adherence. Non-OSA causes of sleepiness should be identified and treated before initiating pharmacotherapy for persistent sleepiness despite adequately treated OSA. Further research on the identification of factors that promote EDS in the setting of OSA is needed to aid in the development of better treatment options.


Excessive daytime sleepiness; Hypersomnia; Hypersomnolence; Persistent sleepiness; Sleep apnea; Sleep disorders; Therapy; Treatment resistance

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