Fatigue, tiredness, and lack of energy improve with treatment for OSA

Many patients with obstructive sleep apnea complain of fatigue, tiredness, or lack of energy in addition to sleepiness, or instead of sleepiness. We explored whether self-defined fatigue, tiredness, and lack of energy improve, like sleepiness, after treatment with positive airway pressure (PAP).

We conducted a prospective survey of adults referred to a University-based sleep disorders center and confirmed to have obstructive sleep apnea on polysomnography. Surveys were mailed to 1539 patients 6 months to 3 years after they were prescribed PAP for home use.

Participants (n = 313) included 183 who reported using PAP > or = 5 hours per night, 96 who were considered inadequately treated because they had no active treatment or used PAP < 5 hours per night, and 34 treated by surgery or other means and therefore excluded from subsequent analysis. At follow-up in comparison to baseline, subjects adherent to PAP reported less fatigue, tiredness, lack of energy, and sleepiness (p < 0.05 for each). Improvement of each symptom except for lack of energy was significantly better (p < 0.05) among PAP-adherent subjects than among inadequately treated subjects.

Patients' complaints of fatigue, tiredness, and lack of energy, like sleepiness, can improve substantially with good adherence to PAP for obstructive sleep apnea. Therefore, patients who prefer a range of common, related terms other than sleepiness to describe their problem may benefit from investigation and treatment for any underlying sleep-disordered breathing.