Neuropsychological functioning and determinants of morning alertness in patients with obstructive sleep apnea syndrome

Abstract

Neuropsychological functioning is reported to be impaired in patients suffering from obstructive sleep apnea syndrome (OSAS). This syndrome is characterized by nocturnal respiratory disturbances, blood oxygen desaturations, sleep fragmentation, and excessive daytime sleepiness. Opinions arc divided concerning the exact relationship between the observed cognitive deficits, nocturnal hypoxia, sleep disruption, and impaired daytime alertness. In the present study, morning neuropsychological function of 26 moderate to severe middle-aged sleep apneics is compared to that of 22 primary insomniacs. There were no performance differences on a range of neuropsychological tests among the two patient groups. In addition, the data suggest that morning alertness impairment, which is closely associated with a lack of slow wave sleep (SWS) and rapid eye movement (REM) sleep, is of major importance in inducing poorer cognitive performance in patients with moderate to severe sleep apnea. (JINS, 1996, 2,306–314.)

A review of executive functions in obstructive sleep apnea syndrome

“…The rest of the studies comprise heterogeneous patient groups in terms of the severity of OSAS. Patients with moderate to severe sleep apnea were studied in 14 studies (19, 20, 23, 27, 28, 30, 32, 33, 35, 45–49) and with mild to severe sleep apnea in 13 studies (17, 21, 22, 29, 37–40, 50–54). For three studies (25, 34, 55) it was not possible to establish the range of the severity of OSAS.…”

“…A selected group of patients was recruited in 29 of the 40 studies (18–20, 24, 25, 28, 30, 31, 33–38, 41–55). In nine studies the patient sample was drawn from consecutive cases (21–23, 26, 27, 29, 32, 39, 40).…”

The Effect of Infective Exacerbations on Sleep and Neurobehavioral Function in Cystic Fibrosis

“…They assess reaction time, which is sensitive to partial or complete sleep deprivation (25). The absolute amount of REM sleep has also been correlated with intellectual functioning (26) and declines markedly in the case of organic brain dysfunctions of the elderly (27). In addition, both sleep fragmentation and hypoxemia are well-recognized contributors to impaired cognitive function and increased daytime sleepiness in patients with sleep apnea/hypopnea syndrome (1).…”

Neurocognitive function in obstructive sleep apnoea: A meta‐review

“…When selecting control participants, a number of the reviews utilized results from studies that had recruited control participants who were likely to have had sleeping problems, for example non-apneoic snorers, 41 or individuals with insomnia. 67,68 Further, few original studies conducted sleep studies formally to determine the absence of OSA and instead selected individuals on the basis of screening questionnaires. Given that estimates of undiagnosed OSA are as high as 82%, 2 this presents a problem both for control studies and for normative comparisons and, by extension, for meta-analyses.…”