Under reporting of sleepiness and driving impairment in patients with sleep apnoea/hypopnoea syndrome

Under reporting of symptoms by patients with sleep apnoea/hypopnoea syndrome (SAHS) has been reported anecdotally, but investigation of the prevalence or determinants of this is limited. To assess this, repeated ratings in 99 patients with sleep apnoea/hypopnoea syndrome of pre-treatment Epworth sleepiness score, unintended napping, driving impairment and mood were obtained, first at presentation and then after treatment with continuous positive airway pressure (CPAP) therapy of median 22 (range 2-70) weeks duration. Median Epworth score for pre-treatment sleepiness rose from 12 (range 0-24) initially to 14 (range 5-24) retrospectively (P or = 11) Epworth score comprised 24% of all patients and 62% of initially 'normal' scorers. Unintended napping behaviour also was rated as significantly more severe on retrospective assessment (P0.1). These results suggest a high prevalence of symptom minimization before treatment in patients with sleep apnoea/hypopnoea syndrome.