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: Obstructive sleep apnea results in intermittent hypoxia via repetitive upper airway obstruction leading to partial or complete upper airway closure, apneas and hypopneas, respectively. Intermittent hypoxia leads to sympathetic nervous system activation and oxidative stress with a resultant systemic inflammatory cascade. The putative mechanism by which obstructive sleep apnea has been linked to numerous pathologic conditions including stoke, cardiovascular disease, hypertension, and metabolic derangements is through these systemic effects. Treatment of obstructive sleep apnea appears to reduce systemic markers of inflammation and ameliorates the adverse sequelae of this disease.Seminars in Respiratory and Critical Care Medicine 10/2014; 35(5):531-44. · 2.75 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). · 1.05 Impact Factor