The Effects of CPAP Treatment on Resting-State Network Centrality in Obstructive Sleep Apnea Patients

Abstract

Background and ObjectivesObstructive sleep apnea (OSA) is the most common sleep disorder and previous studies have shown that OSA patients suffer from brain network impairments associated with cognitive deficits, and continuous positive airway pressure (CPAP) treatment can improve clinical symptoms. However, the relationship between CPAP treatment and brain network changes remains unclear. This study explored the characteristics of brain network changes in OSA patients before (pre-CPAP) and after one month of CPAP treatment (post-CPAP).MethodsWe collected data, including sleep monitoring, clinical assessment, and magnetic resonance imaging scans, from 21 OSA patients and 21 age-matched healthy controls (HCs). Voxel-level degree centrality (DC) was used to assess whole-brain network connectivity characteristics, a two-sample t-test was used to compare network differences between pre-CPAP OSA patients and HCs, and a paired sample t-test was used to compare the characteristics of brain network changes in OSA patients before and after treatment. The correlations between the DC value and each of the clinical variables were analyzed in the OSA patients.ResultsCompared with HCs, pre-CPAP OSA patients showed increased DC values in the bilateral cerebellar posterior lobes (CPLs) and decreased DC values in the right superior temporal gyrus, left superior frontal gyrus and right middle frontal gyrus. Compared with pre-CPAP OSA patients, post-CPAP OSA patients showed reduced DC values in the bilateral CPL and increased DC values in several brain regions in the frontal, temporal, and insular lobes after CPAP treatment. The Montreal Cognitive Assessment MoCA (MoCA) scores were positively correlated with the DC value of the bilateral cerebellum posterior lobe, right middle temporal gyrus, left superior temporal gyrus, left paracentral lobule and left paracentral lobule. Also, Pittsburgh Sleep Quality Index (PSQI) scores were negatively correlated with the DC value of the right middle temporal gyrus in post-CPAP OSA patients.ConclusionCPAP treatment can effectively reverse the compensatory response of the bilateral CPL and functional network damage brought about by OSA, which may provide potential neuroimaging biomarkers for CPAP treatment evaluation.

Aberrant amplitude of low-frequency fluctuations in different frequency bands and changes after one-night positive airway pressure treatment in severe obstructive sleep apnea

“…Park et al ( 46 ) found that OSA showed decreased network integration connectivity in the cerebellum, which was susceptible to hypoxia or ischemia. After long-term CPAP treatment, patients with OSA may have increased cerebellar volume ( 47 , 48 ). In our study, even one-night CPAP treatment can reverse the brain function of the cerebellum.…”

Genetically predicted insomnia causally increases the risk of erectile dysfunction

“…Further randomized control trial showed that the adherent continuous positive airway pressure (CPAP) therapy could improve the sleep-related erectile function in OSA patients, possibly via attenuating OSA-induced hypoxia. 12 13 Another cross-sectional study enrolling 754 males reported that male night shift workers had lower International Index of Erectile Function (IIEF) scores than male non-night shift workers. 11 Additionally, according to Seehuus and Pigeon, 14 insomnia severity was significantly associated with sexual dysfunction and sleep disorders may function in the occurrence of ED.…”

Obstruktive Schlafapnoe – Einfluss auf kardiovaskuläres System und Kognition

“…The morphologically detectable changes are partially reversible by successful PAP therapy 66 121 122 123 . The irreversible morphologic brain changes are associated with residual daytime sleepiness despite adequate therapy 64 78 124 .…”