For decades, the gold standard for success in treating Obstructive Sleep Apnea (OSA) has been the Apnea-Hypopnea Index (AHI). If a patient’s airway is open and their respiratory events are suppressed, the clinical box is checked, and the treatment is deemed a success. However, a growing body of evidence—and the lived experience of countless patients—suggests that this metrics-driven approach often fails to capture the full scope of patient recovery.
Even when OSA is effectively treated with positive airway pressure (PAP) therapy or alternative interventions, a significant cohort of patients continues to suffer from Excessive Daytime Sleepiness (EDS). This persistent fatigue is not merely a nuisance; it is a profound clinical challenge that compromises work performance, fractures interpersonal relationships, degrades cognitive function, and erodes overall quality of life.
To address this critical gap in sleep medicine, Sleep Review is hosting a comprehensive, expert-led webinar on May 29, 2026, titled "Managing Residual Excessive Daytime Sleepiness in Treated OSA Patients." This event marks a pivot in the field: moving away from a narrow focus on respiratory metrics and toward a patient-centered model that prioritizes functional outcomes and emerging therapeutic strategies.
Main Facts: The Persistence of EDS
The core challenge facing sleep specialists in 2026 is the disconnect between physiological normalization and symptomatic relief. While CPAP therapy remains the most effective tool for preventing the collapse of the upper airway, it does not always reset the biological clock or reverse the neurological impacts of chronic sleep fragmentation.
The Shift in Diagnostic Focus
The upcoming webinar aims to deconstruct the "AHI-centric" mindset. Presenters will argue that the AHI, while vital for initial diagnosis, is an insufficient marker for long-term patient health. Residual EDS—defined as persistent sleepiness despite adherence to treatment—requires a nuanced, multi-modal assessment.
The webinar will focus on three key pillars of modern management:
- Real-world Functional Outcomes: Moving beyond lab-based data to understand how patients function in their professional and personal lives.
- Patient-Reported Symptoms: Empowering patients to define their own recovery through validated screening tools.
- Emerging Pharmacological and Behavioral Strategies: Exploring the next generation of treatments for those who remain symptomatic despite airway management.
Chronology of the Clinical Evolution
The narrative of OSA treatment has evolved through three distinct phases, leading to the current emphasis on residual symptoms.
Phase 1: The Era of Airway Patency (1990s–2010)
During this period, the medical community focused almost exclusively on the mechanics of sleep-disordered breathing. The primary objective was to eliminate snoring and apnea. Success was measured solely by the reduction of the AHI to below five events per hour.
Phase 2: The Adherence Crisis (2010–2020)
As diagnostic rates climbed, researchers realized that even if an airway was "fixed," patients were failing to use their devices. The focus shifted to telemonitoring, mask comfort, and patient education. While this improved the numbers, it revealed a hidden population: those who used their machines faithfully but still felt exhausted.
Phase 3: The Functional Outcomes Era (2020–Present)
We are currently in the midst of a paradigm shift. Clinicians are now recognizing that EDS is a multifactorial condition involving chronic inflammation, disrupted circadian rhythms, and metabolic dysfunction. The 2026 webinar represents the formalization of this shift, emphasizing that "treated" does not always mean "well."
Supporting Data: Why the AHI Fails the Patient
Data suggests that as many as 10% to 20% of patients who are fully compliant with PAP therapy continue to report significant daytime sleepiness. This discrepancy between the device readout and the patient’s internal experience creates a "clinical gaslighting" effect, where patients feel discouraged because their machine says they are "doing fine," yet their bodies signal otherwise.
Cognitive and Economic Impacts
Studies highlighted in the lead-up to this event demonstrate the high cost of untreated residual EDS:
- Cognitive Decline: Chronic sleepiness in treated OSA is linked to impairments in executive function, working memory, and attention, which can be catastrophic in safety-sensitive industries.
- Relationship Strain: The irritability and social withdrawal associated with persistent fatigue lead to significantly higher rates of relationship breakdown among patients compared to the general population.
- Economic Burden: Workplace productivity losses due to EDS are estimated to cost billions annually, with "presenteeism"—being at work but unable to function—representing a major, hidden portion of this expense.
Expert Perspectives and Official Responses
The webinar will feature two of the field’s most prominent voices, Dr. Edward Mezerhane and Dr. Laura Bogan Herpel. Both bring a wealth of experience in bridging the gap between sleep laboratory data and clinical reality.
Dr. Edward Mezerhane, MD, FAASM, FACP, DABOM, CPI
Dr. Mezerhane, a board-certified sleep specialist and researcher, has long advocated for a personalized approach to sleep medicine. His work centers on the intersection of obesity medicine and sleep disorders. He posits that for many patients, OSA is a symptom of a larger metabolic dysregulation, and that treating the apnea is only the first step in a broader health recovery program.
Dr. Laura Bogan Herpel, MD, FCCP
As a pulmonologist and sleep expert, Dr. Herpel brings a critical eye to the management of comorbid conditions. Her research often highlights the role of underlying inflammatory processes and the necessity of screening for secondary sleep disorders—such as restless leg syndrome or periodic limb movement disorder—that may persist even after the airway is cleared.
Implications for Clinical Practice
The implications of this shift are profound for sleep technicians, respiratory therapists, and physicians.
Rethinking the Follow-up
For years, the follow-up appointment for an OSA patient has been: "Look at the download, check the AHI, see you in a year." The webinar will challenge this, suggesting that follow-up appointments should instead include:
- Standardized patient-reported outcome measures (PROMs).
- Deep-dive assessments into lifestyle factors, including diet, light exposure, and medication side effects.
- A candid conversation about the definition of "success"—moving from "compliance" to "restoration."
The Role of Technology
The webinar will also address the rise of consumer wearables. While these devices have limitations, they offer a window into real-world sleep patterns that a one-night polysomnography study cannot replicate. Integrating this data into the clinical decision-making process will be a major point of discussion.
Event Logistics and Participation
The live event is scheduled for Friday, May 29, 2026, at 9:00 AM ET (6:00 AM PT). This timing is designed to accommodate clinicians across the North American time zones.
Continuing Education
Recognizing the importance of this topic for practitioners, the Board of Registered Polysomnographic Technologists (BRPT) has designated this live webinar for a maximum of 1.0 Continuing Sleep Technology Education (CSTE) credits. Participants are reminded that these credits should be claimed only for the time actually spent in attendance.
Accessibility and On-Demand Learning
Understanding that the clinical landscape is fast-paced, Sleep Review ensures that all registrants will have access to the session recording. Even those who cannot join the live Q&A are encouraged to register, as the link to the recording will be delivered directly to their inbox shortly after the event concludes.
For those looking to prepare for this upcoming discussion, the organizers have made parts one and two of the "Excessive Daytime Sleepiness" series available on-demand. These foundational sessions provide the necessary background on the pathophysiology of EDS and the current state of diagnostic technology.
Conclusion: A Call to Action
The 2026 webinar series represents more than just professional development; it is a call to action for the sleep medicine community. It serves as a reminder that the goal of medicine is not merely to alter a data point on a screen, but to improve the quality of a human life.
By shifting the focus from the AHI to the patient, sleep specialists can begin to address the silent epidemic of residual sleepiness. As we look toward the future of sleep medicine, the ability to treat the patient behind the mask will be the true measure of success.
Register today at the official Sleep Review website to secure your spot and earn your CSTE credits. Join Dr. Mezerhane and Dr. Herpel as they help redefine the standard of care for 2026 and beyond.
