Immediate and Long-term Neurocognitive Outcome in Patients with Obstructive Sleep Apnea Syndrome After Continuous Positive Airway Pressure Treatment

Abstract

Neurocognitive dysfunction is a major clinical consequence in patients with obstructive sleep apnea syndrome (OSAS). The effects of continuous positive airway pressure (CPAP) treatment, as the gold standard of treatment in OSAS, on this major complication are controversial. The duration and compliance of CPAP are thought to be important factors but evidence is lacking. This study is designed to evaluate the effects of immediate (one night), long-term (3 months) influence and the compliances of CPAP treatment on the neurocognitive function in OSAS patients. We enrolled newly diagnosed severe OSAS patients. Neurocognitive function test battery, CANTAB (Cambridge Neuropsychological Test Automated Battery), was performed before, one night and 3 months of CPAP treatment. Patients with CPAP compliance rate C 70 % and \ 50 % were grouped into good and poor adherence subjects, respectively. Fourteen patients were enrolled in final analyses. Six of them were in poor compliant group. Improvements in attention domain were found in all subjects after one-night treatment and maintained till threemonth follow-up. Additional improvements in some attention performances and visual memory performances were gained only after three-month treatment. Significant changes of decision-making and response control function were found between good and poor compliance groups after three-month treatment. CPAP can improve some neurocognitive function at the very first day used. Longer treatment of CPAP can additionally improve some other neurocognitive functions. Compliance of CPAP has influence on the recovery of neurocognitive functions in patients with severe OSAS.Electronic supplementary material The online version of this article

Three‐dimensional photography for the evaluation of facial profiles in obstructive sleep apnoea

“…Diagnostic polysomnography was performed in accordance with previous studies and recommendations. 28,29 Sleep staging and respiratory events were determined using standardized definitions. 30 Polysomnography scoring was performed by experienced accredited sleep technologists.…”

Reversible Verbal Memory Integration Deficits in Obstructive Sleep Apnoea

“…In our population, average compliance rate was intermediate (5,1 ± 0.37 h per night). While some neurocognitive functions could benefit from PAP immediately after the beginning of the treatment, additional improvements in other neurocognitive domains might necessitate extended PAP treatment with good clinical compliance for patients with severe OSA ( Lin et al, 2015 ). It was shown that one month of PAP treatment in patients with OSA leads to reduced daytime sleepiness and improved verbal episodic memory ( Rosenzweig et al, 2016 ).…”

“…CPAP has been shown to overcome sleep-related symptoms and increase quality of life ( Laratta et al, 2017 ). Cognitive functions, e.g., visual ( Lin et al, 2015 ) and short-term memory ( Canessa et al, 2011 ), seem to be partially restored by standard OSA treatment such as positive airway pressure (PAP), but the reversibility of OSA-related deficits in verbal memory following PAP treatment needs to be further investigated.…”