Daytime sleepiness in patients with obstructive sleep apnea and associated comorbidities

EDS is highly prevalent in patients with OSA and arterial hypertension, cardiac arrhythmias, cerebrovascular comorbidities (particularly in those with thalamic or pontine lesions), diabetes mellitus, metabolic syndrome, asthma, chronic kidney disease, and cancer. By contrast, EDS appears less prevalent in patients with heart failure, treated cerebrovascular and neurodegenerative disease (particularly in those receiving levodopa, selective serotonin reuptake inhibitors, or bromocriptine), and chronic obstructive pulmonary disease (COPD). In conclusion, in patients with OSA, EDS is perceived differently depending on comorbidity. Consequently, EDS assessment should follow a personalized, multidimensional approach that recognizes its clinical relevance while accounting for variability across comorbid conditions.