The Psychosocial Aspects of Obstructive Sleep Apnea

Brown, Wyatt

doi:10.1055/s-2005-864199

Cited by 32 publications

(27 citation statements)

References 81 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Both excessive daytime sleepiness and nocturnal hypoxemia seem to equally contribute to cognitive deficits 60–62. Moreover, excessive daytime sleepiness has been mostly related to impairment in attention, vigilance, and memory function, while hypoxemia tends to correlate with deficits in EF 57,61. In this light, our findings are suggestive for a causative role of nocturnal hypoxemia in executive impairment, considering that the levels of subjective perceived daytime sleepiness are comparable with the normal control subjects ( P = 0.232).…”

Section: Discussionsupporting

confidence: 60%

“…In general, the most common documented cause of sleep related breathing disorders in children can be considered as upper airway obstruction, with prevalence for OSAS of about 1%–3%, and a peak prevalence between 2 and 8 years of age 49. The symptoms of OSAS include abnormal position during sleep,50–52 mood disorders,9,53–56 reduced quality of life, and cognitive problems57 at all ages. Moreover, considering the increasing prevalence of OSAS and neurocognitive and cardiovascular consequences, an objective evaluation with nocturnal monitoring for children with suspected OSAS has been recommended 58,59…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Executive dysfunction in children affected by obstructive sleep apnea syndrome: an observational study

Esposito¹,

Antinolfi²,

Gallai³

et al. 2013

NDT

View full text Add to dashboard Cite

IntroductionThe role of sleep in cognitive processes can be considered clear and well established. Different reports have disclosed the association between sleep and cognition in adults and in children, as well as the impact of disturbed sleep on various aspects of neuropsychological functioning and behavior in children and adolescents. Behavioral and cognitive dysfunctions can also be considered as related to alterations in the executive functions (EF) system. In particular, the EF concept refers to self-regulatory cognitive processes that are associated with monitoring and controlling both thought and goal directed behaviors. The aim of the present study is to assess the impact of the obstructive sleep apnea syndrome (OSAS) on EF in a large sample of school aged children.Materials and methodsThe study population comprised 79 children (51 males and 28 females) aged 7–12 years (mean 9.14 ± 2.36 years) with OSAS and 92 healthy children (63 males and 29 females, mean age 9.08 ± 2.44 years). To identify the severity of OSAS, an overnight respiratory evaluation was performed. All subjects filled out the Italian version of the Modified Card Sorting Test to screen EFs. Moreover, to check the degree of subjective perceived daytime sleepiness, all subjects were administered the Pediatric Daytime Sleepiness Scale (PDSS).ResultsNo significant differences between the two study groups were found for age (P = 0.871), gender (P = 0.704), z-score of body mass index (P = 0.656), total intelligence quotient (P = 0.358), and PDSS scores (P = 0.232). The OSAS children showed a significantly higher rate of total errors (P < 0.001), perseverative errors (P < 0.001), nonperseverative errors (P < 0.001), percentage of total errors (P < 0.001), percentage of perseverative errors (P < 0.001), and percentage of nonperseverative errors (P < 0.001). On the other hand, OSAS children showed a significant reduction in the number of completed categories (P = 0.036), total correct sorts (P = 0.001), and categorizing efficiency (P < 0.001). The Pearson’s correlation analysis revealed a significant positive relationship between all error parameters and apnea-hypopnea index, oxygen desaturation index, and percentage of mean desaturation of O2 with a specular negative relationship between the error parameters and the mean oxygen saturation values, such as a significant negative relationship between apnea-hypopnea index, oxygen desaturation index, percent of mean desaturation of O2, and the number of completed categories.ConclusionOur study identified differences in the executive functioning of children affected by OSAS and is the first to identify a correlation between alteration in respiratory nocturnal parameters and EF that has not yet been reported in developmental age. These findings can be considered as the strength and novelty of the present report in a large pediatric population.

show abstract

Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Executive dysfunction in children affected by obstructive sleep apnea syndrome: an observational study

Esposito¹,

Antinolfi²,

Gallai³

et al. 2013

NDT

View full text Add to dashboard Cite

show abstract

“…Moreover, it is well known that the characterization of disease severity should not be based only on the AHI, but also on clinical features (mainly the disease duration) which are often not easily measurable. Previous studies showed that impairment in attention, vigilance and memory function is mostly related to EDS, while hypoxemia correlates more with deficits in executive functions (Bédard et al ., 1991; Décary et al ., 2000; Engleman et al ., 2000; Brown, 2005). In our sample we found a negative correlation between EDS and verbal memory tests, while no significant correlation between oximetric data and executive functions tests was reported.…”

Section: Discussionmentioning

confidence: 99%

Cognitive profile and brain morphological changes in obstructive sleep apnea

et al. 2011

View full text Add to dashboard Cite

Obstructive sleep apnea (OSA) is accompanied by neurocognitive impairment, likely mediated by injury to various brain regions. We evaluated brain morphological changes in patients with OSA and their relationship to neuropsychological and oximetric data. Sixteen patients affected by moderate-severe OSA (age: 55.8±6.7 years, 13 males) and fourteen control subjects (age: 57.6±5.1 years, 9 males) underwent 3.0 Tesla brain magnetic resonance imaging (MRI) and neuropsychological testing evaluating short and long-term memory, executive functions, language, attention, praxia and non-verbal learning. Volumetric segmentation of cortical and subcortical structures and voxel-based morphometry (VBM) were performed. Patients and controls differed significantly in Rey Auditory- Verbal Learning test (immediate and delayed recall), Stroop test and Digit span backward scores. Volumes of cortical gray matter (GM), right hippocampus, right and left caudate were smaller in patients compared to controls, with also brain parenchymal fraction (a normalized measure of cerebral atrophy) approaching statistical significance. Differences remained significant after controlling for comorbidities (hypertension, diabetes, smoking, hypercholesterolemia). VBM analysis showed regions of decreased GM volume in right and left hippocampus and within more lateral temporal areas in patients with OSA. Our findings indicate that the significant cognitive impairment seen in patients with moderate-severe OSA is associated with brain tissue damage in regions involved in several cognitive tasks. We conclude that OSA can increase brain susceptibility to the effects of aging and other clinical and pathological occurrences.

show abstract

“…Since sleep-related breathing disorders may occur at times of critical brain development in children, neuropsychological disorders may appear later and may be irreversible. 1,15,16 Adenotonsillectomy has been found to improve behaviour in most children, if obturation was the result of adenotonsillar hypertrophy. Three to 10 months after adenotonsillectomy, behavioural improvement occurred regardless of age, sex, parental education and income.…”

Section: Discussionmentioning

confidence: 98%