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Durtette A, Dargent B, Gierski F, Barbe C, Deslée G, Perotin JM, Henry A, Launois C. Impact of continuous positive airway pressure on cognitive functions in adult patients with obstructive sleep apnea: A systematic review and meta-analysis. Sleep Med 2024; 123:7-21. [PMID: 39226674 DOI: 10.1016/j.sleep.2024.08.019] [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: 05/21/2024] [Revised: 07/26/2024] [Accepted: 08/16/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is associated with the impairment of a range of cognitive functions. Whether treatment with continuous positive airway pressure (CPAP) improves these cognitive functions is still a matter of debate. METHODS We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) that included OSA patients (apnea hypopnea index, AHI >10/h), naive to CPAP treatment, with a cognitive assessment before and after CPAP initiation. We compared CPAP versus sham-CPAP or placebo tablet or dietary rules or no treatment. This systematic review and meta-analysis were registered in PROSPERO (ID CRD42021275214). RESULTS Eleven RCTs encompassing 923 OSA patients were included. For most of them, CPAP initiation was ≤3 months. A significant post-treatment improvement was found for the Trail Making Test part B (TMT-B; SMD = -0.93, 95 % CI = [-1.60, -0.25], Z = -2.70, p = 0.007), but not for the other neuropsychological assessments. No global effects on other cognitive domains (information processing speed, executive functions, working memory) were found. CONCLUSION The significant improvement in the TMT-B supports a short-term enhancement in cognitive flexibility with CPAP treatment. Further studies that take into account OSA comorbidities, cognitive profiles, a more diverse range of cognition assessments and include long-term evaluations are needed.
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Affiliation(s)
- Apolline Durtette
- Université de Reims Champagne Ardenne, Laboratoire C2S (Cognition, Santé, Société), UR 6291, France
| | - Barbara Dargent
- Service des Maladies Respiratoires, Centre Hospitalier Universitaire de Reims, 45, Rue de Cognacq-Jay, CEDEX, 51092, Reims, France
| | - Fabien Gierski
- Université de Reims Champagne Ardenne, Laboratoire C2S (Cognition, Santé, Société), UR 6291, France
| | - Coralie Barbe
- Université de Reims Champagne Ardenne, Laboratoire C2S (Cognition, Santé, Société), UR 6291, France; Comité Universitaire de Ressources pour La Recherche en Santé, Université de Reims Champagne-Ardenne, UFR Médecine, 51 Rue Cognacq Jay, 51100, REIMS, France
| | - Gaétan Deslée
- Service des Maladies Respiratoires, Centre Hospitalier Universitaire de Reims, 45, Rue de Cognacq-Jay, CEDEX, 51092, Reims, France; INSERM UMRS 1250, Université de Reims Champagne Ardenne, 51100, Reims, France
| | - Jeanne-Marie Perotin
- Service des Maladies Respiratoires, Centre Hospitalier Universitaire de Reims, 45, Rue de Cognacq-Jay, CEDEX, 51092, Reims, France; INSERM UMRS 1250, Université de Reims Champagne Ardenne, 51100, Reims, France
| | - Audrey Henry
- Université de Reims Champagne Ardenne, Laboratoire C2S (Cognition, Santé, Société), UR 6291, France
| | - Claire Launois
- Service des Maladies Respiratoires, Centre Hospitalier Universitaire de Reims, 45, Rue de Cognacq-Jay, CEDEX, 51092, Reims, France; INSERM UMRS 1250, Université de Reims Champagne Ardenne, 51100, Reims, France.
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Filchenko I, Duss SB, Salzmann S, Brill AK, Korostovtseva L, Amelina V, Baillieul S, Bernasconi C, Schmidt MH, Bassetti CLA. Early sleep apnea treatment in stroke (eSATIS) - a multicentre, randomised controlled, rater-blinded, clinical trial: The association of post-stroke cognition with sleep-disordered breathing and its treatment. J Sleep Res 2024:e14296. [PMID: 39251407 DOI: 10.1111/jsr.14296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 06/22/2024] [Accepted: 07/13/2024] [Indexed: 09/11/2024]
Abstract
Sleep-disordered breathing (SDB) is linked to cognitive dysfunction. Although SDB is common in stroke patients, the impact of SDB and its early treatment on cognitive functioning after stroke remains poorly investigated. Therefore, we explored the association between SDB and post-stroke cognitive functioning, including the impact of early SDB treatment with adaptive servo-ventilation (ASV) on cognitive recovery from acute event to 3 months post-stroke. We used data from two studies, which included ischaemic stroke patients (n = 131) and no-stroke controls (n = 37) without SDB (apnea-hypopnea index, AHI <5/h) and with SDB (AHI≥20/h). Cognitive functioning was assessed within 7 days and 3 months post-stroke in stroke patients, or at study inclusion in no-stroke control group, respectively. Stroke patients with SDB were randomized to ASV treatment (ASV+) or usual care (ASV-). Linear regression adjusted for main confounders assessed the impact of SDB and its treatment on cognitive recovery. The intention-to-treat analysis did not show significant associations of SDB ASV+ (n = 30) versus SDB ASV- (n = 29) with cognitive recovery. In an exploratory subanalysis, compliant SDB ASV+ (n = 14) versus SDB ASV- showed improvements with ASV in visual memory and cognitive flexibility. Combining the stroke and non-stroke datasets, SDB (n = 85) versus no-SDB (n = 83) was associated with deficits in visual memory and response inhibition independently of stroke. SDB ASV- versus no-SDB (n = 51) was associated with less improvement in visual memory. There was no substantial evidence for benefits of intention-to-treat ASV on cognitive recovery. Exploratory analysis indicated that compliant ASV treatment could benefit visual memory and cognitive flexibility, whereas untreated SDB could contribute to a poor recovery of visual memory.
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Affiliation(s)
- Irina Filchenko
- Department of Neurology, Bern University Hospital (Inselspital) and University of Bern, Bern, Switzerland
- Interdisciplinary Sleep-Wake-Epilepsy Centre, Bern University Hospital (Inselspital) and University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Simone B Duss
- Department of Neurology, Bern University Hospital (Inselspital) and University of Bern, Bern, Switzerland
- Interdisciplinary Sleep-Wake-Epilepsy Centre, Bern University Hospital (Inselspital) and University of Bern, Bern, Switzerland
| | - Saskia Salzmann
- Department of Neurology, Bern University Hospital (Inselspital) and University of Bern, Bern, Switzerland
- Interdisciplinary Sleep-Wake-Epilepsy Centre, Bern University Hospital (Inselspital) and University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
- Division of Neuropaediatrics, Development and Rehabilitation, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Anne-Kathrin Brill
- Interdisciplinary Sleep-Wake-Epilepsy Centre, Bern University Hospital (Inselspital) and University of Bern, Bern, Switzerland
- Department for Pulmonary Medicine, Allergology and Clinical Immunology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Lyudmila Korostovtseva
- Laboratory of Somnology, Almazov National Medical Research Centre, Sankt-Peterburg, Russia
| | - Valeria Amelina
- Laboratory of Somnology, Almazov National Medical Research Centre, Sankt-Peterburg, Russia
| | - Sébastien Baillieul
- Univ. Grenoble Alpes, Inserm, U1300, CHU Grenoble Alpes, Service Universitaire de Pneumologie Physiologie, Grenoble, France
| | - Corrado Bernasconi
- Department of Neurology, Bern University Hospital (Inselspital) and University of Bern, Bern, Switzerland
- Interdisciplinary Sleep-Wake-Epilepsy Centre, Bern University Hospital (Inselspital) and University of Bern, Bern, Switzerland
| | - Markus H Schmidt
- Department of Neurology, Bern University Hospital (Inselspital) and University of Bern, Bern, Switzerland
- Interdisciplinary Sleep-Wake-Epilepsy Centre, Bern University Hospital (Inselspital) and University of Bern, Bern, Switzerland
| | - Claudio L A Bassetti
- Department of Neurology, Bern University Hospital (Inselspital) and University of Bern, Bern, Switzerland
- Interdisciplinary Sleep-Wake-Epilepsy Centre, Bern University Hospital (Inselspital) and University of Bern, Bern, Switzerland
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Bondopadhyay U, Diaz-Orueta U, Coogan AN. A Systematic Review of Sleep and Circadian Rhythms in Children with Attention Deficit Hyperactivity Disorder. J Atten Disord 2022; 26:149-224. [PMID: 33402013 DOI: 10.1177/1087054720978556] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Children and adults with ADHD often report sleep disturbances that may form part of the etiology and/or symptomatology of ADHD. We review the evidence for sleep changes in children with ADHD. METHODS Systematic review with narrative synthesis assessing sleep and circadian function in children aged 5 to 13 years old with a diagnosis of ADHD. RESULTS 148 studies were included for review, incorporating data from 42,353 children. We found that sleep disturbances in ADHD are common and that they may worsen behavioral outcomes; moreover, sleep interventions may improve ADHD symptoms, and pharmacotherapy for ADHD may impact sleep. CONCLUSION Sleep disturbance may represent a clinically important feature of ADHD in children, which might be therapeutically targeted in a useful way. There are a number of important gaps in the literature. We set out a manifesto for future research in the area of sleep, circadian rhythms, and ADHD.
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Affiliation(s)
- Upasana Bondopadhyay
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth
| | - Unai Diaz-Orueta
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth
| | - Andrew N Coogan
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth
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Association between primary headaches and temporomandibular disorders: A systematic review and meta-analysis. J Am Dent Assoc 2021; 153:120-131.e6. [PMID: 34649707 DOI: 10.1016/j.adaj.2021.07.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 07/02/2021] [Accepted: 07/21/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND The primary objective of this systematic review was to answer the following question systematically: Is there any association between primary headaches (PHs) and temporomandibular disorders (TMDs) in adults? TYPES OF STUDIES REVIEWED The protocol was registered with the International Prospective Register of Systematic Reviews. The authors performed the search in 7 main databases and 3 gray literature sources. The included articles had to have adult samples. PHs must have been diagnosed using the International Classification of Headache Disorders, and TMDs must have been diagnosed using Research Diagnostic Criteria for Temporomandibular Disorders, Diagnostic Criteria for Temporomandibular Disorders, or International Classification of Orofacial Pain. Risk of bias was evaluated using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument tools. The meta-analysis was performed using Review Manager software, Version 5.4. Certainty of evidence was screened according to Grading of Recommendations Assessment, Development and Evaluation. RESULTS Eight of 2,574 articles reviewed met the inclusion criteria for qualitative analysis and, of these, 6 met the inclusion criteria for quantitative analysis. Odds ratios (ORs) for painful TMD and tension-type headache (OR, 3.16; 95% CI, 1.80 to 5.54 to OR, 13.06; 95% CI, 2.79 to 61.12), migraines (OR, 5.35; 95% CI, 3.04 to 9.40 to OR, 6.22; 95% CI, 3.81 to 10.14), and chronic headaches (OR, 40.40; 95% CI, 8.67 to 188.15 to OR, 95.93; 95% CI, 12.53 to 734.27) were calculated. Articular TMDs without pain were evaluated in only 1 article, in which ORs of 1.78 (95% CI, 0.90 to 3.51) for migraines and 1.04 (95% CI, 0.53 to 2.06) for tension-type headache were reported. Three studies were classified as moderate risk of bias and 5 as low risk of bias. The certainty of evidence varied between very low and low. CONCLUSIONS AND PRACTICAL IMPLICATIONS Recognizing the positive association between painful TMD and PHs can help dentists and physicians treat the pain and avoid it, or recommend the patient to a specialist.
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