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Continuous Positive Airway Pressure in Patients without Daytime Sleepiness
- Ferran Barbé, MD;
- Lola R. Mayoralas, PhD; and
- Alvar G.N. Agusti, MD
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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.
Ferran Barbé, MD
Lola R. Mayoralas, PhD
Alvar G.N. Agusti, MD
Hospital Son Dureta
07014 Palma de Mallorca, Spain
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
