Neuropsychological sequelae of obstructive sleep apnea-hypopnea syndrome: a critical review.
ABSTRACT Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a well-recognized clinical sleep disorder that results in chronically fragmented sleep and recurrent hypoxemia. The primary daytime sequelae of the disorder include patient reports of excessive daytime sleepiness, depression, and attention and concentration problems. It has been well established that OSAHS negatively impacts certain aspects of cognitive functioning. The primary goals of this article are to (1) clarify the pattern of cognitive deficits that are specific to OSAHS; (2) identify the specific cognitive domains that improve with treatment; and (3) elucidate the possible mechanisms of cognitive dysfunction in OSAHS. At the conclusion of the paper, we propose a potential neurofunctional theory to account for the etiology of cognitive deficits in OSAHS. Thirty-seven peer-reviewed articles were selected for this review. In general, findings were equivocal for most cognitive domains. Treatment, however, was noted to improve attention/vigilance in most studies and consistently did not improve constructional abilities or psychomotor functioning. The results are discussed in the context of a neurofunctional theory for the effects of OSAHS on the brain.
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ABSTRACT: Intermittent hypoxia has generally been perceived as a high risk stimulus, particularly in the field of sleep medicine, because it is thought to initiate detrimental cardiovascular, cognitive and metabolic outcomes. In contrast, the link between intermittent hypoxia and beneficial outcomes has received less attention, perhaps because it is not universally understood that outcome measures following exposure to intermittent hypoxia may be linked to the administered dose. The present review is designed to emphasize the less recognized beneficial outcomes associated with intermittent hypoxia. The review will consider the role intermittent hypoxia has in cardiovascular and autonomic adaptations, respiratory motor plasticity and cognitive function. Each section will highlight the literature that contributed to the belief that intermittent hypoxia leads primarily to detrimental outcomes. The second segment of each section will consider the possible risks associated with experimentally rather than naturally induced intermittent hypoxia. Lastly, the body of literature indicating that intermittent hypoxia initiates primarily beneficial outcomes will be considered. The overarching theme of the review is that the use of intermittent hypoxia in research investigations, coupled with reasonable safeguards, should be encouraged because of the potential benefits linked to the administration of a variety of low risk intermittent hypoxia protocols. Copyright © 2014, Journal of Applied Physiology.Journal of Applied Physiology 12/2014; DOI:10.1152/japplphysiol.00564.2014 · 3.43 Impact Factor
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ABSTRACT: Obstructive Sleep Apnea Syndrome (OSAS) is characterized by desaturation in blood oxygen level and sleep fragmentation because of repeated upper airway obstruction. Auditory Event related potentials (AERPs) are scalp recorded voltage fluctuations, which reflect several cognitive processes generated within specific brain regions during auditory stimulus processing. In this study, we aimed to investigate cognitive deficits in OSAS patients with AERPs by taking the effects of aging factor into consideration. AERPs were recorded using an auditory oddball paradigm from 27 OSAS patients (range 28 to 67 years old) and 29 healthy control subjects (range 23 to 60 years old) participated in the study. To evaluate the effects of aging, both the OSAS patients and the controls were divided into two age groups: younger (<45 years) and older (≥45 years). Amplitudes and latencies of N100, P200, N200 and P300 responses to oddball target stimuli were analyzed by repeated measures analyses of variance (ANOVA). Statistical analyses indicate that the P300 amplitudes were lower (P < 0.001), and P300 latencies were longer (P < 0.001) in OSAS patients. However, AERPs when analyzed according to age groups: P300 latencies were significantly longer in both younger and older OSAS patients (P < 0.05) but P300 amplitudes were not different in older OSAS patients compared to controls (P > 0.05). Our results suggest that negative effects of OSAS on cognitive functions could be observed with event-related brain responses. Changes in the P300 latencies are more robust evidence than other AERP components in evaluating cognitive deficits in OSAS patients.Sleep and Biological Rhythms 11/2014; 13(1). DOI:10.1111/sbr.12076 · 0.76 Impact Factor