Dados do Trabalho

Título

MULTIDISCIPLINARY APPROACH TO RESIDUAL DAYTIME SLEEPINESS IN OBSTRUCTIVE SLEEP APNEA: A CASE REPORT

Introdução

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.

Objetivo

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

Métodos

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

Resultados

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.

Conclusões

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.

Palavras -chave

Sleep disorders, hypersomnolence, sleep quality, multidisciplinarity, sleep pattern