PREVALENCE AND MORBIDITY OF SLEEPINESS IN AN ONLINE SLEEP APNEA PATIENT COHORT

Excessive daytime sleepiness (EDS) is a common presenting symptom among sleep apnea (SA) patients. EDS is widely expected to improve with positive airway pressure (PAP) therapy, however, 12-29% of PAP-adherent patients report persistent sleepiness. Given the impact of EDS, we aim to understand the prevalence of EDS and associated quality-of-life (QOL) outcomes among a non-clinic-based sample of patients engaging in a SA online support, education, and research portal. We conducted a cross-sectional survey among patients with SA through the Sleep Apnea Patient Centered Outcomes Network (MyApnea.Org). Survey measures included demographics, comorbidities, treatment, and QOL outcomes: work productivity and activity impairment (WPAI), physical and mental health (Short-Form Health Survey; SF-12v2), functional outcomes of sleep (FOSQ-10), insomnia (Women’s Health Initiative Insomnia Rating Scale; WHIIRS), depression (World Health Organization Well-being Index; WHO-5), and drowsiness-related driving events. QOL outcomes were examined with descriptive statistics by EDS status (Epworth Sleepiness Score, ESS>and≤10). We further examined differences by EDS using linear regression models adjusted for potential confounders. A sub-sample analysis was performed on those with self-reported PAP adherence averaging ≥6 hours/night. Of the respondents (n=292), 48.3% were female, 68.2% were ≥55 years, 91.4% were non-Hispanic/White, average body mass index was 32.8 kg/m2 (standard deviation: 8.1), and 47% reported sleeping ≤6 hours/night on average. Sleepiness was identified as a precipitating factor for seeking initial treatment for 31% of respondents. Compared to those without EDS, those with EDS reported poorer QOL outcomes (WPAI, SF-12v2, FOSQ-10, WHIIRS, WHO-5, drowsiness-related driving events; all nominal p<0.01). Associations persisted after adjusting for demographics and comorbidities. In sub-sample analyses among 181 (85%) PAP-adherent patients, 29.8% reported residual EDS, and similar associations between EDS and QOL were observed. Patients seeking online SA support experienced a high prevalence of EDS, despite high self-reported PAP adherence. EDS was associated with poorer QOL, including functionality, work, mood, and driving. EDS burden among SA patients despite PAP treatment may drive these individuals to seek online support for problems with sleepiness-related QOL, suggesting potential gaps in clinical care. Jazz Pharmaceuticals