Impaired sustained attention and lapses are present in patients with mild obstructive sleep apnea

Luz, Gabriela Costa Pontes; Guimarães, Thaís; Weaver, Terri E.; Nery, Luíz Eduardo; Silva, Luciana Oliveira e; Badke, Luciana; Coelho, Glaury; Millani-Carneiro, Aline; Tufik, Sérgio; Bittencourt, Lia

doi:10.1007/s11325-015-1279-7

Cited by 26 publications

(12 citation statements)

References 42 publications

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“…Based on these prior findings, one may speculate that aberrant interhemispheric communications between bilateral prefrontal cortex and bilateral premotor and supplementary motor cortex, resulting from abnormal fiber connections, may contribute to the dysfunctions of prospective memory and sustained attention in OSA patients. However, although OSA‐related impairments in sustained attention (Karimi et al, ; Luz et al, ; Simoes, Padilla, Bezerra, & Schmidt, ) and prospective memory (Zhang et al, ) have be previously reported, no significant intergroup differences in these cognitive domains were observed in this study, which may result from the possibility of a type II error due to the small sample size. Of note, the finding of significant correlations between altered diffusion metrics and cognitive performances exhibiting no intergroup differences highlights the multifaceted and complex nature of these relationships, which need to be clarified in a larger sample.…”

Section: Discussioncontrasting

confidence: 99%

Selective microstructural integrity impairments of the anterior corpus callosum are associated with cognitive deficits in obstructive sleep apnea

et al. 2019

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BackgroundThere is some evidence that obstructive sleep apnea (OSA) patients have white matter integrity abnormality in the corpus callosum (CC). However, whether the CC subregions are differentially affected in OSA is largely unknown.MethodsTwenty patients with OSA and 24 well‐matched healthy controls were enrolled and underwent diffusion tensor imaging (DTI) and clinical and cognitive assessments. DTI tractography was used to reconstruct the CC which was divided into five subregions. Intergroup differences in multiple diffusion metrics of each CC subregion and their correlations with clinical and cognitive parameters were tested.ResultsIn comparison with healthy controls, OSA patients exhibited white matter integrity alterations in the anterior CC, characterized by increased radial diffusivity (RD) in the subregion 1 and decreased fractional anisotropy (FA) along with increased mean diffusivity (MD) and RD in the subregion 2. Moreover, we found that the lower microstructural integrity in the anterior CC was correlated with worse prospective memory and sustained attention in OSA patients.ConclusionsThese findings indicate that the selective impairments of the anterior CC may help clarify the neural correlates of cognitive impairments in OSA.

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Section: Discussioncontrasting

confidence: 99%

Selective microstructural integrity impairments of the anterior corpus callosum are associated with cognitive deficits in obstructive sleep apnea

et al. 2019

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“…The novelty of our study was the investigation of both mild and moderate to severe OSA in middle‐aged and older adults, which led to a better understanding of how OSA affects brain health with aging. Our results add to previous findings showing that mild OSA may lead to adverse outcomes (Jahn, Gouveris, & Matthias, ; Luz et al, ). Strengths of our study include the combined use of multiple neuroimaging techniques, including FW imaging, a novel measurement that improves results interpretation.…”

Section: Discussionsupporting

confidence: 89%

Cerebral white matter diffusion properties and free‐water with obstructive sleep apnea severity in older adults

Baril

Gagnon

Descoteaux

et al. 2020

Human Brain Mapping

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Characterizing the effects of obstructive sleep apnea (OSA) on the aging brain could be key in our understanding of neurodegeneration in this population. Our objective was to assess white matter properties in newly diagnosed and untreated adults with mild to severe OSA. Sixty‐five adults aged 55 to 85 were recruited and divided into three groups: control (apnea‐hypopnea index ≤5/hr; n = 18; 65.2 ± 7.2 years old), mild (>5 to ≤15 hr; n = 27; 64.2 ± 5.3 years old) and moderate to severe OSA (>15/hr; n = 20; 65.2 ± 5.5 years old). Diffusion tensor imaging metrics (fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity, and mean diffusivity) were compared between groups with Tract‐Based Spatial Statistics within the white matter skeleton created by the technique. Groups were also compared for white matter hyperintensities volume and the free‐water (FW) fraction. Compared with controls, mild OSA participants showed widespread areas of lower diffusivity (p < .05 corrected) and lower FW fraction (p < .05). Participants with moderate to severe OSA showed lower AD in the corpus callosum compared with controls (p < .05 corrected). No between‐group differences were observed for FA or white matter hyperintensities. Lower white matter diffusivity metrics is especially marked in mild OSA, suggesting that even the milder form may lead to detrimental outcomes. In moderate to severe OSA, competing pathological responses might have led to partial normalization of diffusion metrics.

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“…Otherwise, some authors found cognitive deficit (PVT) in patients with mild OSA [ 31 ]. Luz and colleagues (2015), for instance, compared PVT of mild OSA patients with normal individuals and found that those patients had more lapses than normal individuals, in accordance with our results [ 1 ].…”

Section: Discussionsupporting

confidence: 90%

“…However, these aspects are still controversial on mild OSA. Recently, one study showed that patients with mild OSA presented more lapses during sustained attention evaluation compared to normal subjects [ 1 – 3 ].…”

Section: Introductionmentioning

confidence: 99%

Upper Airway Resistance Syndrome Patients Have Worse Sleep Quality Compared to Mild Obstructive Sleep Apnea

et al. 2016

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PurposeTo compare sleep quality and sustained attention of patients with Upper Airway Resistance Syndrome (UARS), mild Obstructive Sleep Apnea (OSA) and normal individuals.MethodsUARS criteria were presence of excessive daytime sleepiness (Epworth Sleepiness Scale—ESS—≥ 10) and/or fatigue (Modified Fatigue Impact Scale—MFIS—≥ 38) associated to Apnea/hypopnea index (AHI) ≤ 5 and Respiratory Disturbance Index (RDI) > 5 events/hour of sleep or more than 30% of total sleep time with flow limitation. Mild OSA was considered if the presence of excessive daytime sleepiness (ESS ≥ 10) and/or fatigue (MFIS ≥ 38) associated to AHI ≥ 5 and ≤ 15 events/hour. “Control group” criteria were AHI < 5 events/hour and RDI ≤ 5 events/hour and ESS ≤ 9, without any sleep, clinical, neurological or psychiatric disorder. 115 individuals (34 UARS and 47 mild OSA patients and 34 individuals in “control group”), adjusted for age, gender, body mass index (BMI) and schooling years, performed sleep questionnaires and sustained attention evaluation. Psychomotor Vigilance Task (PVT) was performed five times (each two hours) from 8 a.m. to 4 p.m.ResultsUARS patients had worse sleep quality (Functional Outcomes of Sleep Questionnaire—FOSQ—and Pittsburgh Sleep Quality Index—PSQI: p < 0.05) and more fatigue than mild OSA patients (p = 0.003) and scored significantly higher in both Beck inventories than “control group” (p < 0.02). UARS patients had more lapses early in the morning (in time 1) compared to the results in the afternoon (time 5) than mild OSA (p = 0.02). Mild OSA patients had more lapses in times 2 than in time 5 compared to “control group” (p = 0.04).ConclusionsUARS patients have a worse sleep quality, more fatigue and a worse early morning sustained attention compared to mild OSA. These last had a worse sustained attention than controls.

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Impaired sustained attention and lapses are present in patients with mild obstructive sleep apnea

Abstract: Patients with mild OSA showed increased sustained attention lapses compared with normal subjects.

Cited by 26 publications

References 42 publications

Selective microstructural integrity impairments of the anterior corpus callosum are associated with cognitive deficits in obstructive sleep apnea

Selective microstructural integrity impairments of the anterior corpus callosum are associated with cognitive deficits in obstructive sleep apnea

Cerebral white matter diffusion properties and free‐water with obstructive sleep apnea severity in older adults

Upper Airway Resistance Syndrome Patients Have Worse Sleep Quality Compared to Mild Obstructive Sleep Apnea

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