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REPLY
Continuous Positive Airway Pressure in Patients without Daytime Sleepiness
Ferran Barbé, MD;
Lola R. Mayoralas, PhD; and
Alvar G.N. Agusti, MD
3 September 2002 | Volume 137 Issue 5 Part 1 | Page 370
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.
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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
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Author and Article Information
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Hospital Son Dureta; 07014 Palma de Mallorca, Spain
1. Chervin RD, Guilleminault C. Assessment of sleepiness in clinical practice Nat Med. 1995;1:1252-3. [PMID: 7489403].
2. 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].
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Articles
Treatment with Continuous Positive Airway Pressure Is Not Effective in Patients with Sleep Apnea but No Daytime Sleepiness: A Randomized, Controlled Trial
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
- Annals 2001 134: 1015-1023.
[ABSTRACT][SUMMARY][Full Text]
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Letters
Continuous Positive Airway Pressure in Patients without Daytime Sleepiness
Lawrence E. Kline AND Arthur Dawson
- Annals 2002 137: 369-370.
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