Javier Espinar Sierra’s research while affiliated with Complutense University of Madrid and other places

To evaluate the psychological disturbances associated with obstructive sleep apnea (OSA) and the effect of nasal continuous positive airway pressure (NCPAP) treatment on these alterations, personality patterns and psychosocial adjustment were assessed in patients hypnopolygraphically diagnosed with OSA before and after different periods of NCPAP therapy. Prior to treatment, MMPI results for 23 patients showed significant elevations (p < .01) on five clinical scales compared to those of 17 normal controls. Apneics' personality patterns were predominantly of a "neurotic-mixed" type, indicating an anxiety reaction with paranoid features. Depression, schizophrenia, and hypochondriasis were the highest scales. Most patients had severe psychosocial maladjustment. In the follow-up study during the NCPAP treatment, there was a progressive reduction of the psychopathological signs along with a generalized improvement in psychosocial adaptation. These changes were remarkably significant after about a year's treatment, in particular for depression (p < .01) and total adjustment degree (p < .01). It was concluded that severe OSA is associated with serious psychosocial alterations that improve gradually with NCPAP.

En este artículo se revisan los principales trastornos del sueño, en particular aquéllos que son más frecuentes durante la infancia. subrayando su vinculación al desarrollo neuropsicológico del niño. Tras una breve exposición de las características del sueño normal y de sus mecanismos neurofisiológicos, se describen los distintos trastornos del sueño y se exponen la utilidad del estudio en el laboratorio de sueño para cada uno de ellos.

The sleep pattern of 13 prepubertal children, nonmedicated, rigourously diagnosed as Attention Deficit Disorder (ADD) was recorded for two consecutive nights. Analyses of sleep pattern variables revealed a marked reduction of sleep onset latency (p less than .01), a great number of nocturnal awakenings (p less than .01), and a high increase of Delta sleep percentage (p less than .01) for the ADD children compared to normals. In addition, the two subtypes of the disorder--ADD with hyperactivity (ADD/H) and ADD without hyperactivity (ADD/WO) or ADD undifferentiated--showed distinct hypnopolygraphic correlates. Those ADD/H children had a greater sleep fragmentation and a lesser degree of sleep efficiency. These findings would support the hypothesis that ADD is related to a deficient control of arousal level and, on the other hand, suggest that ADD/H and ADD/WO are different clinical entities.