Continuous Positive Airway Pressure in Patients without Daytime Sleepiness
Authors: Ferran Barbé
Journal: Annals of Internal Medicine (2002)

Letters3 September 2002Continuous Positive Airway Pressure in Patients without Daytime SleepinessFerran Barbé, MD, Lola R. Mayoralas, PhD, and Alvar G.N. Agusti, MDFerran Barbé, MDHospital Son Dureta; 07014 Palma de Mallorca, SpainSearch for more papers by this author, Lola R. Mayoralas, PhDHospital Son Dureta; 07014 Palma de Mallorca, SpainSearch for more papers by this author, and Alvar G.N. Agusti, MDHospital Son Dureta; 07014 Palma de Mallorca, SpainSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-5_Part_1-200209030-00023 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Dr. Kline and colleagues for their interest in our paper, and we are happy to respond to their comments. First, based on the MSLT results shown in our Figure 2, Kline and colleagues suggest that some of our patients had pathologic daytime sleepiness. In our study, we did not use the MSLT to define pathologic daytime sleepiness. Instead, we used the Epworth Sleepiness Scale because it is the tool most widely used to evaluate daytime sleepiness in clinical practice (the MSLT is time-consuming and is not routinely used). Furthermore, there are some concerns regarding the accuracy of the MSLT for the quantitative assessment of sleepiness (1, 2). Kline and colleagues also suggest that a separate analysis of the patients with pathologic MSLT scores might be useful. As reported in our manuscript, we performed such analysis in patients with an MSLT score of less than 10 minutes. The Table on page 369 shows the results obtained in the subgroup of patients with an MSLT score less than 5 minutes. In these patients, as in those originally analyzed in our study, continuous positive airway pressure did not improve sleep latency time, quality of life, or cognitive function. We therefore believe that available evidence does not support treatment with continuous positive airway pressure in patients without subjective daytime sleepiness.Table. Quality of Life, Daytime Sleepiness, and Results on Psychological Tests before and after 6 Weeks of Treatment in Patients with a Baseline MSLT Score of Less than 5 Minutes References1. Chervin RD, Guilleminault C. Assessment of sleepiness in clinical practice. Nat Med. 1995;1:1252-3. [PMID: 7489403] CrossrefMedlineGoogle Scholar2. Sangal RB, Thomas L, Mitler MM. Maintenance of wakefulness test and multiple sleep latency test. Measurement of different abilities in patients with sleep disorders [see comments]. Chest. 1992;101:898-902. [PMID: 1555459] CrossrefMedlineGoogle Scholar Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: Hospital Son Dureta; 07014 Palma de Mallorca, Spain PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTreatment with Continuous Positive Airway Pressure Is Not Effective in Patients with Sleep Apnea but No Daytime Sleepiness Ferran Barbé , Lola R. Mayoralas , Joaquin Duran , Juan F. Masa , Andreu Maimó , Josep M. Montserrat , Carmen Monasterio , Margalida Bosch , Antoni Ladaria , Manuela Rubio , Ramon Rubio , Magdalena Medinas , Lourdes Hernandez , Silvia Vidal , Neil J. Douglas , and Alvar G.N. Agustí Continuous Positive Airway Pressure in Patients without Daytime Sleepiness Lawrence E. Kline and Arthur Dawson Continuous Positive Airway Pressure in Patients without Daytime Sleepiness Lawrence E. Kline and Arthur Dawson Metrics 3 September 2002Volume 137, Issue 5_Part_1Page: 370KeywordsCognitionContinuous positive airway pressureQuality of lifeSleep ePublished: 3 September 2002 Issue Published: 3 September 2002 CopyrightCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...