A Wake-Up Call: Improving Recognition and Management of Excessive Daytime Sleepiness in Patients with Obstructive Sleep Apnea – Tweetorial #2




Provided by Integrity Continuing Education, Inc.


This activity is supported by independent educational grants from Jazz Pharmaceuticals, Inc.


Diagnosis of excessive daytime sleepiness (EDS) in obstructive sleep apnea (OSA)


OSA is a highly prevalent disorder that is growing in incidence in tandem with an obesity epidemic believed to be at the etiologic core of this chronic respiratory disorder. EDS is the most common (but not universal) symptom of OSA — it is also the most overlooked and neglected. While many health care providers (HCPs) are appropriately managing breathing obstruction with continuous positive airway pressure (CPAP), EDS often remains under-identified and unassessed, therefore chronically unaddressed.

Perhaps the assumption is that CPAP will resolve this bothersome issue or that EDS, in and of itself, is not significant enough to treat. Research reveals that both suppositions are incorrect. Studies have revealed that even regular, consistent use of CPAP does not diminish persistent sleepiness in up to half of OSA patients. Other research has revealed that disturbed sleep plays a strong role in the etiology of obesity and cardiovascular disease risk, both of which are common in patients with OSA. EDS also reduces quality of life (QOL) and ability to function well in daily life, while simultaneously increasing the risk for motor vehicle or workplace accidents. Outcomes for patients with OSA and EDS could be improved if physicians and other clinicians learned to acknowledge, ask about, and manage EDS in their OSA patients who continue to struggle with sleepiness despite adherence to CPAP.


Kori Ascher, DO
Pulmonary, Critical Care, and Sleep Medicine
University of Miami
Miami, Florida


Seema Khosla, MD, FCCP, FAASM
Medical Director
Sleep Medicine
North Dakota Center for Sleep
Fargo, North Dakota

Release date: December, 8, 2021
Expiration date: December, 8, 2022
Estimated time to complete activity: 15 minutes

This educational activity has been designed to meet the needs of sleep specialists, including neurologists, psychiatrists, and pulmonologists; primary care providers; nurse practitioners; physician assistants; and other HCPs involved in the care of patients with residual EDS in patients with OSA.


Upon completion of this educational activity, participants should be able to:

  • Improve recognition and diagnosis of EDS in OSA patients

There are no fees for participating and receiving CME credit for this activity. During the period of December 8, 2021 through December 8, 2022, participants must:

  • Read the learning objectives and faculty disclosures
  • Complete the pretest
  • Study the educational activity
  • Complete the posttest and the evaluation form

A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed posttest with a score of 100%.




Physician Continuing Education 

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Integrity Continuing Education, Inc. designates this other activity for a maximum of 0.25 AMA PRA Category 1 Credit. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


For information about ACCME accreditation of this activity, please contact Integrity Continuing Education, Inc. at (855) 835-4004 or cme@integrityce.com.


Integrity Continuing Education, Inc. requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Integrity Continuing Education, Inc. for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations. All relevant financial relationships have been mitigated.

The following faculty/planners reported the financial relationships or relationships to products or devices they have with ineligible companies related to the content of these CME activities:

Kori Ascher, MD has no real or apparent conflicts of interest to disclose.

Seema Khosla, MD, FCCP, FAASM
Stocks: Inspire Medical Systems
Discussion Facilitator: Jazz

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