Abstract
BACKGROUND: Six to ten percent of patients with obstructive sleep apnea suffer from residual excessive daytime sleepiness (rEDS) despite adequate nocturnal positive airway pressure therapy or effective alternative treatment. The differential diagnosis of rEDS is an interdisciplinary challenge in clinical practice. OBJECTIVES: Development of a clear guideline for the detection, differential diagnostic considerations, and options for the continuing treatment of rEDS in clinical practice. METHODS: MeSH analysis-based research and interdisciplinary consensus among specialists in internal medicine and pneumology, neurology, as well as psychiatry and psychotherapy. RESULTS: The SPAIN checklist for systematic differential diagnostic exploration of rEDS with the parameters: S leep behavior, P sychological causes, A namesis of medication, I nternal causes and N eurological causes. CONCLUSIONS: rEDS should be recognized as a symptom worthy of treatment. It requires an interdisciplinary assessment and the individual adaptation of the treatment to the needs of the affected person.