Overnight Motor Skill Learning Outcomes in Obstructive Sleep Apnea: Effect of Continuous Positive Airway Pressure

Abstract

Study Objective: To determine the effectiveness of continuous positive airway pressure (CPAP) therapy in alleviating known impairments in the overnight consolidation of motor skill learning in patients with obstructive sleep apnea (OSA). Methods: Twenty-five patients with untreated moderate-severe OSA, 13 first-night CPAP users, 17 compliant CPAP users, and 14 healthy control patients were trained on a motor sequence learning task (Sequential Finger Tapping Task, SFTT) and were subsequently tested prior to and after polysomnographic recorded sleep. Measures of subjective sleepiness (Karolinska Sleepiness Scale) and sustained attention (Psychomotor Vigilance Task) were also completed before and after sleep. Results: Typical analyses of overnight improvement on the SFTT show significantly greater overnight gains in motor task speed in controls (+11.6 ± 4.7%, p = 0.007) and compliant CPAP users (+8.9 ± 4.3%, p = 0.008) compared to patients with OSA (−4.86 ± 4.5%). Additional analyses suggest that these improvements in motor performance occurred prior to the sleep episode, as all groups significantly improved (15% to 22%) over a 10-min presleep rest period. Thereafter, performance in all groups significantly deteriorated over sleep (6% to 16%) with trends toward patients with OSA showing greater losses in performance compared to control patients and compliant CPAP users. No between-group differences in subjective sleepiness and sustained attention were found presleep and postsleep. Conclusions: The current data suggest impairments in overnight motor learning in patients with OSA may be a combination of deficient stabilization of memory over a sleep episode as well as increased vulnerability to time on task fatigue effects. Compliant CPAP usage possibly offsets both of these impediments to learning outcomes by improving both sleep quality and subsequent daytime function. Keywords: cognitive impairment, consolidation, CPAP, learning, memory, motor skills, obstructive sleep apnea, OSA, sleep dependent Citation: Landry S, O'Driscoll DM, Hamilton GS, Conduit R. Overnight motor skill learning outcomes in obstructive sleep apnea: effect of continuous positive airway pressure.

Memory consolidation in sleep disorders

“…These results were further corroborated by Landry and colleagues [54]. The authors assessed the effect of CPAP treatment on the overnight consolidation of motor skills in 17 compliant CPAP users (M age ¼ 48.5 y) relative to 24 patients with untreated OSA (M age ¼ 47.2 y), 13 patients with first-night CPAP (M age ¼ 47.7 y), and 14 controls (M age ¼ 47.0 y).…”

Can Daytime Napping Assist the Process of Skills Acquisition After Stroke?

“…Lastly, while participants were screened for sleep disorders they did not undergo a night with polysomnographic recordings to fully exclude possible non-detected disorders. Disordered sleep is common in stroke patients and might impact learning ( 70 , 71 ).…”

Adult Gross Motor Learning and Sleep: Is There a Mutual Benefit?

“…Thus, defining sleep disorders, which may negatively influence motor performance in these risk groups, should be considered in physiotherapy. Improving sleep disturbances with pharmacological and nonpharmacological interventions may be assumed to in turn improve learning outcomes, as already demonstrated in patients with OSA [ 138 ]. Considering that learning complex GML tasks affects sleep architecture [ 76 , 78 ], we anticipate a reciprocal effect: on one side, sleep disturbances might be normalized by motor performance; on the other side, normal sleep can stabilize and enhance GML gains.…”