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Condoleo V, Bonfrate L, Armentaro G, Pelaia C, Cassano V, De Marco M, Severini G, Pastura CA, Miceli S, Maio R, Perticone M, Arturi F, Sesti G, Sciacqua A. Effects of continuous positive airway pressure on comprehensive geriatric assessment and cognitive function in elderly patients with obstructive sleep apnea syndrome. Intern Emerg Med 2023; 18:769-779. [PMID: 36808594 DOI: 10.1007/s11739-023-03220-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 02/07/2023] [Indexed: 02/23/2023]
Abstract
Obstructive sleep apnea syndrome (OSAS) can lead to cognitive impairment and depression affecting memory, attention, and executive functions. Continuous positive airway pressure (CPAP) treatment seems to be able to revert changes in brain networks and neuropsychological tests correlated to OSAS. The aim of the present study was to evaluate the effects of a 6-month treatment with CPAP on functional, humoral and cognitive parameters in a cohort of elderly OSAS patients with several comorbidities. We enrolled 360 elderly patients suffering from moderate to severe OSAS and indication for nocturnal CPAP. At baseline the Comprehensive Geriatric Assessment (CGA) revealed a borderline Mini-Mental State Examination (MMSE) score that improved after 6-month treatment with CPAP (25.3 ± 1.6 vs 26 ± 1.5; p < 0.0001), as well as the Montreal Cognitive Assessment (MoCA) showed a mild improvement (24.4 ± 2.3 vs 26.2 ± 1.7; p < 0.0001). Moreover, functionality activities increased after treatment, as documented by a short physical performance battery (SPPB) (6.3 ± 1.5 vs 6.9 ± 1.4; p < 0.0001). Reduction of the Geriatric Depression Scale (GDS) from 6.0 ± 2.5 to 4.6 ± 2.2 (p < 0.0001) was also detected. Changes of homeostasis model assessment (HOMA) index, oxygen desaturation index (ODI), sleep-time spent with saturation below 90% (TC90), peripheral arterial oxyhaemoglobin saturation (SpO2), apnea-hypopnea index (AHI) and estimation of glomerular filtration rate (eGFR), contributed, respectively, to 27.9%, 9.0%, 2.8%, 2.3%, 1.7% and 0.9% of MMSE variability for a total of 44.6% of MMSE variations. GDS score changes were due to the improvement of AHI, ODI and TC90, respectively, for 19.2%, 4.9%, 4.2% of the GDS variability, cumulative responsible for 28.3% of GDS modifications. The present real-world study shows that CPAP treatment is able to improve cognition and depressive symptoms in OSAS elderly patients.
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Affiliation(s)
- Valentino Condoleo
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa - Località Germaneto, 88100, Catanzaro, Italy
| | - Leonilde Bonfrate
- Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Giuseppe Armentaro
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa - Località Germaneto, 88100, Catanzaro, Italy.
| | - Corrado Pelaia
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa - Località Germaneto, 88100, Catanzaro, Italy
| | - Velia Cassano
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa - Località Germaneto, 88100, Catanzaro, Italy
| | - Mario De Marco
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa - Località Germaneto, 88100, Catanzaro, Italy
| | - Giandomenico Severini
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa - Località Germaneto, 88100, Catanzaro, Italy
| | - Carlo Alberto Pastura
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa - Località Germaneto, 88100, Catanzaro, Italy
| | - Sofia Miceli
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa - Località Germaneto, 88100, Catanzaro, Italy
| | - Raffaele Maio
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa - Località Germaneto, 88100, Catanzaro, Italy
| | - Maria Perticone
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa - Località Germaneto, 88100, Catanzaro, Italy
| | - Franco Arturi
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa - Località Germaneto, 88100, Catanzaro, Italy
| | - Giorgio Sesti
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario "S. Venuta", Viale Europa - Località Germaneto, 88100, Catanzaro, Italy
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Pilot cohort study of obstructive sleep apnoea in community-dwelling people with schizophrenia. Ir J Psychol Med 2020; 38:23-29. [DOI: 10.1017/ipm.2020.11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objectives:We aimed to assess the incidence of obstructive sleep apnoea (OSA) in people with schizophrenia, to explore clinical associates with OSA and how well OSA screening tools perform in this population.Methods:All patients registered in a community outpatient Clozapine clinic, between January 2014 and March 2016, were consecutively approached to participate. Participants were screened for OSA using at home multichannel polysomnography (PSG) and were diagnosed with OSA if the apnoea-hypopnoea index (AHI) was >10 events/hr. Univariate comparison of participants to determine whether AHI > 10 events/hr was associated with demographic factors, anthropometric measures and psychiatric symptoms and cognition was performed. The sensitivity, specificity, positive predictive value and negative predictive value of the commonly used sleep symptoms scales and OSA screening tools were also determined.Results:Thirty participants were recruited, 24 men and 6 women. Mean age was 38.8 (range: 25–60), and mean body mass index (BMI) was 35.7 (range 19.9–62.1). The proportion of participants with OSA (AHI > 10 events/hr) was 40%, 18 (60%) had no OSA, 4 (13%) had mild OSA (AHI 10.1–20), zero participants had moderate OSA (AHI 20.1–30) and 8 (27%) had severe OSA (AHI > 30). Diagnosis of OSA was significantly associated with increased weight, BMI, neck circumference and systolic blood pressure. Diagnosis of OSA was not significantly associated with Positive and Negative Symptoms Scale, Montgomery Asperger’s Depression Rating Scale, Personal and Social Performance scale or Brief Assessment of Cognition for Schizophrenia scores. All OSA screening tools demonstrated poor sensitivity and specificity for a diagnosis of OSA.Conclusion:OSA was highly prevalent in this cohort of people with schizophrenia and was associated with traditional anthropometric OSA risk factors.
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Fernando HJ, Cohen R, Gullett JM, Friedman J, Ayzengart A, Porges E, Woods AJ, Gunstad J, Ochoa CM, Cusi K, Gonzalez-Louis R, Donahoo WT. Neurocognitive Deficits in a Cohort With Class 2 and Class 3 Obesity: Contributions of Type 2 Diabetes and Other Comorbidities. Obesity (Silver Spring) 2019; 27:1099-1106. [PMID: 31116012 PMCID: PMC6666310 DOI: 10.1002/oby.22508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 04/02/2019] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study examined the relationship between specific metabolic and vascular risk factors and cognition in adults with severe obesity. METHODS A total of 129 adults (with BMI ≥ 35 kg/m2 ) underwent a baseline clinical evaluation and neuropsychological assessment. Regression analyses examined the relationship between cognition and medical factors (BMI, hemoglobin A1c, diabetes, hypertension, continuous positive airway pressure use, obstructive sleep apnea [OSA], and osteoarthritis). RESULTS Diabetes was associated with deficits in overall cognitive performance and with deficits in the executive processing speed and verbal fluency domains. Hemoglobin A1c was inversely related to overall cognitive performance and deficits in the attention domain. Participants using continuous positive airway pressure to treat OSA had stronger learning and memory performance, whereas OSA was associated with reduced total learning. Elevated BMI together with diabetes diagnosis was associated with reduced verbal fluency and greater variability in sustained attention. CONCLUSIONS Obesity-associated comorbidities most notably appeared to have a greater relative influence on cognitive performance than BMI itself in adults with severe obesity. This likely reflects the fact that a very elevated BMI was ubiquitous and thereby probably exerted a similar influence among all adults in the cohort. Accordingly, in the context of severe obesity, diabetes and other comorbidities may have greater sensitivity to cognitive deficits than BMI alone.
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Affiliation(s)
- Heshan J. Fernando
- University of Florida, Department of Clinical and Health Psychology, Gainesville, FL
| | - Ronald Cohen
- University of Florida, Department of Clinical and Health Psychology, Gainesville, FL
| | - Joseph M. Gullett
- University of Florida, Department of Clinical and Health Psychology, Gainesville, FL
| | - Jeffrey Friedman
- University of Florida, Division of General Surgery, Gainesville, FL
| | | | - Eric Porges
- University of Florida, Department of Clinical and Health Psychology, Gainesville, FL
| | - Adam J. Woods
- University of Florida, Department of Clinical and Health Psychology, Gainesville, FL
| | | | - Christa M. Ochoa
- University of Florida, Department of Clinical and Health Psychology, Gainesville, FL
| | - Kenneth Cusi
- University of Florida, Division of Endocrinology, Diabetes & Metabolism, Gainesville, FL
| | - Rachel Gonzalez-Louis
- University of Florida, Department of Clinical and Health Psychology, Gainesville, FL
| | - William T. Donahoo
- University of Florida, Division of Endocrinology, Diabetes & Metabolism, Gainesville, FL
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Myles H, Myles N, Coetzer CLC, Adams R, Chandratilleke M, Liu D, Mercer J, Vakulin A, Vincent A, Wittert G, Galletly C. Cognition in schizophrenia improves with treatment of severe obstructive sleep apnoea: A pilot study. SCHIZOPHRENIA RESEARCH-COGNITION 2018; 15:14-20. [PMID: 30450286 PMCID: PMC6226616 DOI: 10.1016/j.scog.2018.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/20/2018] [Accepted: 09/20/2018] [Indexed: 01/19/2023]
Abstract
Previous studies have shown that people with schizophrenia have high rates of Obstructive Sleep Apnoea (OSA). Despite this, intervention studies to treat OSA in this population have not been undertaken. The ASSET (Assessing Sleep in Schizophrenia and Evaluating Treatment) pilot study investigated Continuous Positive Airway Pressure (CPAP) treatment of severe OSA in participants recruited from a clozapine clinic in Adelaide. Participants with severe untreated OSA (Apnoea-Hypopnoea Index (AHI) > 30), were provided with CPAP treatment, and assessed at baseline and six months across the following domains: physical health, quality of sleep, sleepiness, cognition, psychiatric symptoms and CPAP adherence. Six of the eight ASSET participants with severe OSA accepted CPAP. At baseline, half of the cohort had hypertension, all were obese with a mean BMI of 45, and they scored on average 1.47 standard deviations below the normal population in cognitive testing. The mean AHI was 76.8 and sleep architecture was markedly impaired with mean rapid eye movement (REM) sleep 4.1% and mean slow wave sleep (SWS) 4.8%. After six months of treatment there were improvements in cognition (BACS Z score improved by an average of 0.59) and weight loss (mean weight loss 7.3 ± 9 kg). Half of the participants no longer had hypertension and sleep architecture improved with mean REM sleep 31.4% of the night and mean SWS 24% of the night. Our data suggests CPAP may offer novel benefits to address cognitive impairment and sleep disturbance in people with schizophrenia.
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Affiliation(s)
- Hannah Myles
- School of Medicine, Adelaide University, Adelaide, Australia
- Country Health SA, Mental Health, Australia
| | | | - Ching Li Chai Coetzer
- Adelaide Institute for Sleep Health: A Flinders Centre for Research Excellence, Flinders University, Australia
- Sleep Health Service, Southern Adelaide Local Health Network, SA Health, Australia
| | - Robert Adams
- School of Medicine, Adelaide University, Adelaide, Australia
- The Royal Adelaide Hospital, SA, Australia
- The Health Observatory, Discipline of Medicine, TQEH, Australia
| | - Madhu Chandratilleke
- Adelaide Institute for Sleep Health: A Flinders Centre for Research Excellence, Flinders University, Australia
| | - Dennis Liu
- School of Medicine, Adelaide University, Adelaide, Australia
- Northern Adelaide Local Health Network (NALHN), Australia
| | - Jeremy Mercer
- Adelaide Institute for Sleep Health: A Flinders Centre for Research Excellence, Flinders University, Australia
- Sleep Health Service, Southern Adelaide Local Health Network, SA Health, Australia
| | - Andrew Vakulin
- Adelaide Institute for Sleep Health: A Flinders Centre for Research Excellence, Flinders University, Australia
- NeuroSleep and Woolcock Institute of Medical Research, University of Sydney, Australia
| | - Andrew Vincent
- School of Medicine, Adelaide University, Adelaide, Australia
- Freemasons Foundation Centre for Men's Health, Australia
| | - Gary Wittert
- School of Medicine, Adelaide University, Adelaide, Australia
- Freemasons Foundation Centre for Men's Health, Australia
| | - Cherrie Galletly
- School of Medicine, Adelaide University, Adelaide, Australia
- Northern Adelaide Local Health Network (NALHN), Australia
- Ramsey Health Care (SA) Mental Health, Australia
- Corresponding author at: The Adelaide Clinic, 33 Park Tce, Gilberton, SA 5081, Australia.
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Kang SH, Yoon IY, Lee SD, Kim T. Effects of Continuous Positive Airway Pressure Treatment on Cognitive Functions in the Korean Elderly with Obstructive Sleep Apnea. SLEEP MEDICINE RESEARCH 2016. [DOI: 10.17241/smr.2016.00010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Duffy SL, Lagopoulos J, Terpening Z, Lewis SJG, Grunstein R, Mowszowski L, Cross N, Hermens DF, Hickie IB, Naismith SL. Association of Anterior Cingulate Glutathione with Sleep Apnea in Older Adults At-Risk for Dementia. Sleep 2016; 39:899-906. [PMID: 26856906 DOI: 10.5665/sleep.5650] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 12/14/2015] [Indexed: 12/19/2022] Open
Abstract
STUDY OBJECTIVES Sleep disordered breathing (SDB) is common in older adults and is strongly associated with cognitive decline, with increasing evidence suggesting that it may represent a risk factor for dementia. Given that SDB is characterized by intermittent episodes of hypoxemia during sleep, it is possible that cognitive impairment may relate to cerebral oxidative stress. This study aimed to examine the relationship between nocturnal markers of hypoxemia and proton magnetic resonance spectroscopy ((1)H-MRS) markers of oxidative stress within the anterior cingulate cortex (ACC) of the brain. METHODS Twenty-four older adults (mean age = 67.9 y) at-risk for dementia were recruited from our Healthy Brain Ageing Research Clinic. At-risk was defined as participants seeking help for assessment and/or intervention for cognitive decline, including those with subjective and/or objective cognitive complaints. This could occur in the context of prior depression or risk factors (e.g., vascular) for dementia. All participants underwent psychiatric, medical and neuropsychological assessment followed by overnight polysomnography. In addition, participants underwent (1)H-MRS to derive levels of ACC metabolite glutathione (GSH) reported as a ratio to creatine (GSH/Cr). RESULTS Increased levels of GSH/Cr were associated with lower oxygen desaturation (r = -0.54, P = 0.007) and more severe apnea-hypopnea index scores during rapid eye movement sleep (r = 0.42, P = 0.050). In addition, ACC GSH/Cr correlated with poorer executive functioning (i.e., response inhibition: r = -0.49, P = 0.015; set shifting: r = -0.43, P = 0.037). CONCLUSIONS Markers of nocturnal hypoxemia and SDB are associated with cerebral oxidative stress in older people at-risk for dementia, suggesting a potential mechanism by which SDB may contribute to brain degeneration, cognitive decline, and dementia. Further work focused on utilizing this biomarker for the early identification and treatment of this possible modifiable risk factor in older persons is now warranted.
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Affiliation(s)
- Shantel L Duffy
- Healthy Brain Ageing Program, The University of Sydney, Camperdown, Australia.,Clinical Research Unit, Brain and Mind Centre, The University of Sydney, Camperdown, Australia.,Charles Perkins Centre, School of Psychology, The University of Sydney, Camperdown, Australia.,National Health and Medical Research Council Centre of Research Excellence 'Neurosleep', The University of Sydney, Camperdown, Australia
| | - Jim Lagopoulos
- Clinical Research Unit, Brain and Mind Centre, The University of Sydney, Camperdown, Australia.,National Health and Medical Research Council Centre of Research Excellence 'Neurosleep', The University of Sydney, Camperdown, Australia
| | - Zoe Terpening
- Healthy Brain Ageing Program, The University of Sydney, Camperdown, Australia.,Clinical Research Unit, Brain and Mind Centre, The University of Sydney, Camperdown, Australia.,Charles Perkins Centre, School of Psychology, The University of Sydney, Camperdown, Australia
| | - Simon J G Lewis
- Healthy Brain Ageing Program, The University of Sydney, Camperdown, Australia.,Clinical Research Unit, Brain and Mind Centre, The University of Sydney, Camperdown, Australia.,National Health and Medical Research Council Centre of Research Excellence 'Neurosleep', The University of Sydney, Camperdown, Australia
| | - Ron Grunstein
- Woolcock Institute of Medical Research, Sydney Medical School, The University of Sydney, Camperdown, Australia.,National Health and Medical Research Council Centre of Research Excellence 'Neurosleep', The University of Sydney, Camperdown, Australia
| | - Loren Mowszowski
- Healthy Brain Ageing Program, The University of Sydney, Camperdown, Australia.,Clinical Research Unit, Brain and Mind Centre, The University of Sydney, Camperdown, Australia.,Charles Perkins Centre, School of Psychology, The University of Sydney, Camperdown, Australia
| | - Nathan Cross
- Healthy Brain Ageing Program, The University of Sydney, Camperdown, Australia.,Clinical Research Unit, Brain and Mind Centre, The University of Sydney, Camperdown, Australia.,Charles Perkins Centre, School of Psychology, The University of Sydney, Camperdown, Australia.,Woolcock Institute of Medical Research, Sydney Medical School, The University of Sydney, Camperdown, Australia.,National Health and Medical Research Council Centre of Research Excellence 'Neurosleep', The University of Sydney, Camperdown, Australia
| | - Daniel F Hermens
- Clinical Research Unit, Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| | - Ian B Hickie
- Healthy Brain Ageing Program, The University of Sydney, Camperdown, Australia.,Clinical Research Unit, Brain and Mind Centre, The University of Sydney, Camperdown, Australia.,National Health and Medical Research Council Centre of Research Excellence 'Neurosleep', The University of Sydney, Camperdown, Australia
| | - Sharon L Naismith
- Healthy Brain Ageing Program, The University of Sydney, Camperdown, Australia.,Clinical Research Unit, Brain and Mind Centre, The University of Sydney, Camperdown, Australia.,Charles Perkins Centre, School of Psychology, The University of Sydney, Camperdown, Australia.,National Health and Medical Research Council Centre of Research Excellence 'Neurosleep', The University of Sydney, Camperdown, Australia
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Schwarz JFA, Geisler P, Hajak G, Zulley J, Rupprecht R, Wetter TC, Popp RFJ. The effect of partial sleep deprivation on computer-based measures of fitness to drive. Sleep Breath 2015; 20:285-92. [PMID: 26115651 DOI: 10.1007/s11325-015-1220-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 06/11/2015] [Accepted: 06/16/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Using a partial sleep deprivation paradigm, the aim of the study was to investigate the sensitivity of a computer-based test battery of fitness to drive to detect impairments related to sleepiness. METHODS Forty-seven healthy subjects (34 females, mean age 26.0 ± 6.8 years) participated in a counterbalanced within-subject design of two conditions: (i) normal night sleep and (ii) partial sleep deprivation (PSD) with 4 h time in bed. For the assessment of fitness to drive, we used a validated traffic psychological test battery. Moreover, well-established measures of sleepiness highly responsive to sleep deprivation were applied: the Karolinska Sleepiness Scale (KSS), pupillography (Pupil Unrest Index (PUI) as physiological sleepiness indicator) and two sustained attention tasks (psychomotor Vigilance Task and Mackworth Clock Test). RESULTS Subjective and physiological sleepiness were significantly increased after PSD, accompanied by large (d > 1.50 for KSS) and medium (d = 0.55 for PUI) effect sizes. Sleepiness-related performance decrements were found in both sustained attention tasks (d = 0.59-0.77). Assessing driving-related ability, PSD induced decrements only in the test domain Reaction Test (reaction time d = 0.54 and motor time d = 0.45). All other subtests-as well as the overall judgement of fitness to drive-were not significantly affected by PSD. CONCLUSION In contrast to established tests of sustained attention and subjective sleepiness, computer-based test batteries of fitness to drive might lack sensitivity to core aspects of sleepiness as they mainly consist of short and stimulating subtests. Therefore, tasks that require sustained attention should be an essential part of traffic psychological test batteries when sleepiness is a potential issue.
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Affiliation(s)
- Johanna F A Schwarz
- Department of Psychiatry and Psychotherapy, Center of Sleep Medicine, University of Regensburg, Universitätsstrasse 84, 93053, Regensburg, Germany.,Department of Psychology, Stockholm University, Stockholm, Sweden.,Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Peter Geisler
- Department of Psychiatry and Psychotherapy, Center of Sleep Medicine, University of Regensburg, Universitätsstrasse 84, 93053, Regensburg, Germany
| | - Göran Hajak
- Department of Psychiatry and Psychotherapy, Center of Sleep Medicine, University of Regensburg, Universitätsstrasse 84, 93053, Regensburg, Germany.,Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Social Foundation Bamberg, Bamberg, Germany
| | - Jürgen Zulley
- Department of Psychiatry and Psychotherapy, Center of Sleep Medicine, University of Regensburg, Universitätsstrasse 84, 93053, Regensburg, Germany
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy, Center of Sleep Medicine, University of Regensburg, Universitätsstrasse 84, 93053, Regensburg, Germany
| | - Thomas C Wetter
- Department of Psychiatry and Psychotherapy, Center of Sleep Medicine, University of Regensburg, Universitätsstrasse 84, 93053, Regensburg, Germany
| | - Roland F J Popp
- Department of Psychiatry and Psychotherapy, Center of Sleep Medicine, University of Regensburg, Universitätsstrasse 84, 93053, Regensburg, Germany.
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Djonlagic I, Guo M, Matteis P, Carusona A, Stickgold R, Malhotra A. First night of CPAP: impact on memory consolidation attention and subjective experience. Sleep Med 2015; 16:697-702. [PMID: 25953301 DOI: 10.1016/j.sleep.2015.01.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 12/23/2014] [Accepted: 01/23/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Neurocognitive deficits are common and serious consequences of obstructive sleep apnea (OSA). Currently, the gold standard treatment is continuous positive air pressure (CPAP) therapy, although the clinical responses to this intervention can be variable. This study examined the effect of one night of CPAP therapy on sleep-dependent memory consolidation, attention, and vigilance as well as subjective experience. METHODS Fifteen healthy controls and 29 patients with obstructive sleep apnea of whom 14 underwent a full-night CPAP titration completed the psychomotor vigilance test (PVT) and motor sequence learning task (MST) in the evening and the morning after undergoing overnight polysomnography. All participants also completed subjective evaluations of sleep quality. RESULTS Participants with OSA showed significantly less overnight improvement on the MST compared to controls without OSA, independent of whether or not they had received CPAP treatment, while there was no significant difference between the untreated OSA and CPAP-treated patients. Within the OSA group, only those receiving CPAP exhibited faster reaction times on the PVT in the morning. Compared to untreated OSA patients, they also felt subjectively more rested and reported that they slept better. CONCLUSION Our results demonstrate an instant augmentation of subjective experience and, based on PVT results, attention and vigilance after one night of CPAP, but a lack of an effect on offline sleep-dependent motor memory consolidation. This dissociation may be explained by different brain structures underlying these processes, some of which might require longer continued adherence to CPAP to generate an effect.
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Affiliation(s)
- Ina Djonlagic
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Center for Sleep and Cognition, Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Division of Sleep Medicine, Sleep Disorders Program Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Mengshuang Guo
- Center for Sleep and Cognition, Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Division of Sleep Medicine, Sleep Disorders Program Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Paul Matteis
- Center for Sleep and Cognition, Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Division of Sleep Medicine, Sleep Disorders Program Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Andrea Carusona
- Division of Sleep Medicine, Sleep Disorders Program Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Robert Stickgold
- Center for Sleep and Cognition, Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Atul Malhotra
- Division of Sleep Medicine, Sleep Disorders Program Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA; Division of Pulmonary and Critical Care, University of California San Diego, La Jolla, CA, USA
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Vaessen TJ, Overeem S, Sitskoorn MM. Cognitive complaints in obstructive sleep apnea. Sleep Med Rev 2015; 19:51-8. [DOI: 10.1016/j.smrv.2014.03.008] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 03/25/2014] [Accepted: 03/26/2014] [Indexed: 12/01/2022]
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10
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Pan W, Kastin AJ. Can sleep apnea cause Alzheimer's disease? Neurosci Biobehav Rev 2014; 47:656-69. [DOI: 10.1016/j.neubiorev.2014.10.019] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 08/17/2014] [Accepted: 10/22/2014] [Indexed: 11/29/2022]
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Akcali A, Sahin E, Ergenoglu T, Neyal M. Latency of auditory P300 response is related with cognitive deficits in Obstructive Sleep Apnea Syndrome. Sleep Biol Rhythms 2014. [DOI: 10.1111/sbr.12076] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Aylin Akcali
- Department of Neurology; Faculty of Medicine; Gaziantep University; Gaziantep Turkey
| | - Eylem Sahin
- Neurology Clinic; Kahramanmaras State Hospital; Kahramanmaras Turkey
| | - Tolgay Ergenoglu
- Department of Physiology; Faculty of Medicine; Mersin University; Mersin Turkey
| | - Munife Neyal
- Department of Neurology; Faculty of Medicine; Gaziantep University; Gaziantep Turkey
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Effect of continuous positive airway pressure treatment on short-term memory performance over 24h of sustained wakefulness in patients with obstructive sleep apnea–hypopnea syndrome. Sleep Med 2013; 14:964-72. [DOI: 10.1016/j.sleep.2013.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Revised: 07/01/2013] [Accepted: 07/08/2013] [Indexed: 01/10/2023]
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Cipolli C, Mazzetti M, Plazzi G. Sleep-dependent memory consolidation in patients with sleep disorders. Sleep Med Rev 2013; 17:91-103. [DOI: 10.1016/j.smrv.2012.01.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2011] [Revised: 01/13/2012] [Accepted: 01/14/2012] [Indexed: 11/26/2022]
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Göder R, Born J. Can sleep heal memory? Sleep Med Rev 2012; 17:89-90. [PMID: 23044220 DOI: 10.1016/j.smrv.2012.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 09/03/2012] [Indexed: 11/26/2022]
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Abstract
Obstructive sleep apnea (OSA) is a sleep-related breathing disorder characterized by repetitive episodes of airflow cessation resulting in brief arousals and intermittent hypoxemia. Several studies have documented significant daytime cognitive and behavioral dysfunction that seems to extend beyond that associated with simple sleepiness and that persists in some patients after therapeutic intervention. A still unanswered question is whether cognitive symptoms in OSA are primarily a consequence of sleep fragmentation and hypoxemia, or whether they coexist independently from OSA. Moreover, very little is known about OSA effects on cognitive performances in the elderly in whom an increased prevalence of OSA is present. In this review we will consider recent reports in the association between sleep apnea and cognition, with specific interest in elderly subjects, in whom sleep disturbances and age-related cognitive decline naturally occur. This will allow us to elucidate the behavioral and cognitive functions in OSA patients and to gain insight into age differences in the cognitive impairment. Clinically, these outcomes will aid clinicians in the evaluation of diurnal consequences of OSA and the need to propose early treatment.
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Affiliation(s)
- Emilia Sforza
- Department of Clinical Physiology and Exercise, Pole NOL, CHU, Faculty of Medicine J, Lisfranc, UJM et PRES University of Lyon Saint-Etienne, France
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Fulda S, Schulz H. How treatment affects cognitive deficits in patients with sleep disorders: methodological issues and results. PROGRESS IN BRAIN RESEARCH 2010; 185:69-90. [PMID: 21075234 DOI: 10.1016/b978-0-444-53702-7.00005-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Sleep disorders are frequently associated with impaired performance although the type and extent of cognitive deficits varies widely between different types of sleep disorders. Treatment is expected to ameliorate these deficits. However, cognitive functioning and its change with treatment depend on numerous factors. In this chapter we discuss methodological issues, including test selection, and person-specific, task-specific and environmental factors that influence cognitive functioning. In addition, features of study design and sampling strategies are discussed. The chapter ends with a short overview of routes by which treatment may affect cognition in sleep-disordered patients.
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