PDF(Pubmed)
Abstract：
Excessive daytime sleepiness is common with obstructive sleep apnoea and can persist despite efforts to optimise primary airway therapy. The literature lacks recommendations regarding differential diagnosis and management of excessive daytime sleepiness in obstructive sleep apnoea. This study sought to develop expert consensus statements to bridge the gap between existing literature/guidelines and clinical practice.
A panel of 10 international experts was convened to undertake a modified Delphi process. Statements were developed based on available evidence identified through a scoping literature review, and expert opinion. Consensus was achieved through 3 rounds of iterative, blinded survey voting and revision to statements until a predetermined level of agreement was met (≥80 % voting \"strongly agree\" or \"agree with reservation\").
Consensus was achieved for 32 final statements. The panel agreed excessive daytime sleepiness is a patient-reported symptom. The importance of subjective/objective evaluation of excessive daytime sleepiness in the initial evaluation and serial management of obstructive sleep apnoea was recognised. The differential diagnosis of residual excessive daytime sleepiness in obstructive sleep apnoea was discussed. Optimizing airway therapy (eg, troubleshooting issues affecting effectiveness) was addressed. The panel recognised occurrence of residual excessive daytime sleepiness in obstructive sleep apnoea despite optimal airway therapy and the need to evaluate patients for underlying causes.
Excessive daytime sleepiness in patients with obstructive sleep apnoea is a public health issue requiring increased awareness, recognition, and attention. Implementation of these statements may improve patient care, long-term management, and clinical outcomes in patients with obstructive sleep apnoea.
A panel of 10 international experts was convened to undertake a modified Delphi process. Statements were developed based on available evidence identified through a scoping literature review, and expert opinion. Consensus was achieved through 3 rounds of iterative, blinded survey voting and revision to statements until a predetermined level of agreement was met (≥80 % voting \"strongly agree\" or \"agree with reservation\").
Consensus was achieved for 32 final statements. The panel agreed excessive daytime sleepiness is a patient-reported symptom. The importance of subjective/objective evaluation of excessive daytime sleepiness in the initial evaluation and serial management of obstructive sleep apnoea was recognised. The differential diagnosis of residual excessive daytime sleepiness in obstructive sleep apnoea was discussed. Optimizing airway therapy (eg, troubleshooting issues affecting effectiveness) was addressed. The panel recognised occurrence of residual excessive daytime sleepiness in obstructive sleep apnoea despite optimal airway therapy and the need to evaluate patients for underlying causes.
Excessive daytime sleepiness in patients with obstructive sleep apnoea is a public health issue requiring increased awareness, recognition, and attention. Implementation of these statements may improve patient care, long-term management, and clinical outcomes in patients with obstructive sleep apnoea.
摘要：
目的：白天过度嗜睡是阻塞性睡眠呼吸暂停常见的，尽管努力优化主要气道治疗，但仍可持续。文献缺乏有关阻塞性睡眠呼吸暂停的白天过度嗜睡的鉴别诊断和管理的建议。这项研究旨在制定专家共识声明，以弥合现有文献/指南与临床实践之间的差距。
方法：召集了一个由10名国际专家组成的小组，以进行修改的德尔菲程序。声明是根据通过范围界定文献综述确定的现有证据制定的，和专家意见。通过三轮迭代达成共识，盲目的调查投票和修改声明，直到达到预定的协议水平（≥80％的投票\“强烈同意\”或\“同意保留\”）。
结果：达成了32项最后声明的共识。小组同意白天过度嗜睡是患者报告的症状。认识到在阻塞性睡眠呼吸暂停的初步评估和系列管理中，对白天过度嗜睡的主观/客观评估的重要性。讨论了阻塞性睡眠呼吸暂停中残留的白天过度嗜睡的鉴别诊断。优化气道治疗（例如，解决了影响有效性的故障排除问题)。小组认识到，尽管有最佳的气道治疗，阻塞性睡眠呼吸暂停仍存在残留的白天过度嗜睡，并且需要评估患者的潜在原因。
结论：阻塞性睡眠呼吸暂停患者白天过度嗜睡是一个公共卫生问题，需要提高意识。认可,和注意。实施这些声明可能会改善患者护理，长期管理,阻塞性睡眠呼吸暂停患者的临床结局。
方法：召集了一个由10名国际专家组成的小组，以进行修改的德尔菲程序。声明是根据通过范围界定文献综述确定的现有证据制定的，和专家意见。通过三轮迭代达成共识，盲目的调查投票和修改声明，直到达到预定的协议水平（≥80％的投票\“强烈同意\”或\“同意保留\”）。
结果：达成了32项最后声明的共识。小组同意白天过度嗜睡是患者报告的症状。认识到在阻塞性睡眠呼吸暂停的初步评估和系列管理中，对白天过度嗜睡的主观/客观评估的重要性。讨论了阻塞性睡眠呼吸暂停中残留的白天过度嗜睡的鉴别诊断。优化气道治疗（例如，解决了影响有效性的故障排除问题)。小组认识到，尽管有最佳的气道治疗，阻塞性睡眠呼吸暂停仍存在残留的白天过度嗜睡，并且需要评估患者的潜在原因。
结论：阻塞性睡眠呼吸暂停患者白天过度嗜睡是一个公共卫生问题，需要提高意识。认可,和注意。实施这些声明可能会改善患者护理，长期管理,阻塞性睡眠呼吸暂停患者的临床结局。
