436 Obstructive Sleep Apnea Treatment (e.g., CPAP) Differential Effects on Cognitive Performance

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A172-A173
Author(s):  
Ei Hlaing ◽  
Stephanie Clancy Dollinger ◽  
Terry Brown
Keyword(s):  
Sleep Quality ◽  
Cognitive Deficits ◽  
Daytime Sleepiness ◽  
Short Term Memory ◽  
Cognitive Tests ◽  
Subjective Sleep Quality ◽  
Cognitive Improvement ◽  
Cpap Treatment ◽  
Integrative Research ◽  
Obstructive Sleep

Abstract Introduction The efficacy of CPAP treatment for cognitive improvement among patients with OSA is inconsistent. Naegele et al. (1995) found that short term memory impairment persisted even after 4 to 6 months of CPAP; O’Donoghue et al. (2012) have reported they did not find improvement in vigilance or memory; Felver-Grant (2007) found that working memory improved but not other cognitive tests. Kanbay et al. (2015) found patients improved on the MMSE scores after 3 months of CPAP treatment. Kim et al. (2018) claimed just 3 weeks of CPAP treatment improved attention, sleep quality, and excessive daytime sleepiness (EDS). CPAP therapy has little effect on the improvement of cognitive deficits associated with OSA if the patients did not complain of daytime sleepiness (Zhou et al,, 2016). Methods Both untreated OSA patients (N=19) and ApneaLinkTM- screened controls (N=16) were administered a battery of cognitive tests before the patients started using CPAP and these two conditions were tested again after 3 months of CPAP treatment. A Fisher’s Exact Chi-Square test was used to determine if there was an association between conditions (OSA patients vs. Controls) and level of performance on cognitive tests (low vs. high scores) at the baseline and after 3 months of treatment. Results Depression scores, subjective sleep quality scores (global PSQI), EDS scores (Epworth Sleepiness Scale), and mood disturbance (Profile of Mood States) decreased after 3 months of CPAP treatment just for patients. Controls (individuals without moderate or severe OSA) performed better at the second time on phonemic fluency, immediate recall memory test, and 30 minute delayed memory recall test. Conclusion The fact that patients did not do better at time 2 on any of the cognitive tests may indicate a long term effect of hypoxia on the brain. The cognitive deficits may not reverse within the first 3 months of CPAP although self-reported depressive symptoms and perception of sleep quality and positive mood have improved when patients reported they are compliant with the treatment. Support (if any) A grant from the Center for Integrative Research on Cognitive Neural Science, Southern Illinois University Carbondale was received.

scholarly journals Sleep quality, daytime sleepiness and daytime functioning among Thai obstructive sleep apnea patients receiving continuous positive airway pressure therapy

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Theerakorn Theerakittikul ◽  
Jindarat Chaiard ◽  
Jirawan Deeluea
Keyword(s):  
Sleep Quality ◽  
Daytime Sleepiness ◽  
Positive Airway Pressure ◽  
Quality Of Sleep ◽  
Daytime Functioning ◽  
Content Type ◽  
Cpap Treatment ◽  
Obstructive Sleep

PurposeThe purpose is to assess the effectiveness of continuous positive airway pressure (CPAP) treatment on sleep quality, daytime sleepiness and daytime functioning among Thai obstructive sleep apnea (OSA) patients.Design/methodology/approachA repeated measures clinical intervention design was implemented. Participants were 50 patients first time diagnosed with OSA and prescribed CPAP treatment. The intervention composed of CPAP health education, and follow-up evaluation. Data on CPAP adherence were downloaded from Smartcards of the CPAP device. The Thai PSQI, ESS and FSAQ-10 questionnaires were administered at baseline, 1-month, and 3-months. Descriptive statistics and repeated measure analysis with multilevel mixed-effects modeling approach were used.FindingsThirty-nine participants completed the study. Approximately 53% (n = 25) and 71.1% (n = 27) of the patients adhered to CPAP treatment by the end of the 1- and 3-months, respectively. After controlling for patients’ adherence, at 1-month follow-up, the intervention improved quality of sleep (β = −2.65, 95% CI = −1.60, −4.13), daytime functioning (β = 3.24, 95% CI = 1.87, 4.61) and decreased daytime sleepiness (β = −3.29, 95% CI = −1.85, −4.73). At 3 months, the intervention still improved quality of sleep (β = −3.53, 95% CI = −2.05, −5.01), and daytime functioning (β = 4.34, 95% CI = 2.76, 5.92), and decreased daytime sleepiness (β = −4.82, 95% CI = −3.16, −6.49).Originality/valueAdherence to CPAP treatment is effective in improving sleep quality, daytime functioning and reducing daytime sleepiness. Patient-oriented strategies for enhancing CPAP adherence should be developed and implemented as a standard care in sleep clinics.

scholarly journals The Role of Daytime Sleepiness in Psychosocial Outcomes after Treatment for Obstructive Sleep Apnea

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Esther Yuet Ying Lau ◽  
Gail A. Eskes ◽  
Debra L. Morrison ◽  
Malgorzata Rajda ◽  
Kathleen F. Spurr
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Quality ◽  
Daytime Sleepiness ◽  
Functional Outcomes ◽  
Psychosocial Outcomes ◽  
Activity Level ◽  
Cpap Treatment ◽  
Obstructive Sleep

We investigated the role of daytime sleepiness and sleep quality in psychosocial outcomes of patients with obstructive sleep apnea (OSA) treated with continuous positive airway pressure (CPAP). Thirty-seven individuals with moderate to severe OSA and compliant with CPAP treatment for at least 3 months were compared to 27 age- and education-matched healthy controls. The OSA group and the control group were studied with overnight polysomnography (PSG) and compared on measures of daytime sleepiness (Epworth Sleepiness Scale), sleep quality (Pittsburg Sleep Quality Index), mood (Beck Depression Inventory, Profile of Mood States), and functional outcomes (Functional Outcomes of Sleep Questionnaire). After CPAP treatment, the OSA group improved on sleep quality and sleepiness. As a group, they did not differ from controls on sleep architecture after CPAP. The OSA group also showed significant improvements in functional outcomes and was comparable to controls on mood and functional outcomes. Persistent difficulties included lowered activity level and residual sleepiness in some individuals. Sleepiness was found to be a significant predictor of mood and affective states, while both sleepiness and sleep quality predicted functional outcomes. These results highlight the importance of assessment and intervention targeting psychosocial functioning and sleepiness in individuals with OSA after treatment.

scholarly journals Improvement of Cognitive Function after Continuous Positive Airway Pressure Treatment for Subacute Stroke Patients with Obstructive Sleep Apnea: A Randomized Controlled Trial

2019 ◽  
Vol 9 (10) ◽  
pp. 252 ◽  
Author(s):  
Kim ◽  
Im ◽  
Park ◽  
Kim ◽  
Sohn ◽  
...  
Keyword(s):  
Treatment Group ◽  
Sleep Quality ◽  
Daytime Sleepiness ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Control Group ◽  
Stroke Patients ◽  
Randomized Controlled ◽  
Cpap Treatment ◽  
Obstructive Sleep

Background: Obstructive sleep apnea (OSA) is common after stroke. Various studies on continuous positive airway pressure (CPAP) therapy for OSA after stroke have been published. However, there have been no studies from Korea and Asia. The present Korean study aimed to determine whether CPAP treatment during inpatient rehabilitation of stroke patients with sleep disorders, especially OSA, improves function, cognition, sleep quality, and daytime sleepiness. Methods: This single-blind randomized controlled study included 40 stroke patients with OSA between November 2017 and November 2018. The patients were divided into the CPAP treatment group (CPAP and rehabilitation; n = 20) and control group (only rehabilitation; n = 20). The intervention period was 3 weeks. The primary outcomes were function and cognition improvements, and the secondary outcomes were sleep-related improvements. Results: CPAP treatment started at an average of 4.6 ± 2.8 days after admission. Both groups showed improvements in stroke severity, function, and cognition after the 3-week intervention. However, after the intervention, the degree of change in attention and calculation was significantly higher in the CPAP treatment group than in the control group. Additionally, the improvements in sleep quality and daytime sleepiness were greater in the CPAP treatment group than in the control group. Conclusion: CPAP treatment can improve cognitive function, sleep quality, and daytime sleepiness, and it should be considered as part of the rehabilitation program for patients with stroke. Our findings might help in the treatment of stroke patients with OSA in Korea.

scholarly journals Inspiratory Muscle Training in the Severity of Obstructive Sleep Apnea, Sleep Quality and Excessive Daytime Sleepiness: A Placebo-Controlled, Randomized Trial

2020 ◽  
Vol Volume 12 ◽  
pp. 1105-1113
Author(s):  
José Carlos Nogueira Nóbrega-Júnior ◽  
Armèle Dornelas de Andrade ◽  
Erika Alves Marinho de Andrade ◽  
Maria do Amparo Andrade ◽  
Alice Santana Valadares Ribeiro ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Quality ◽  
Randomized Trial ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Muscle Training ◽  
Obstructive Sleep

scholarly journals 0416 Poor Sleep Quality Predicts Serum Markers of Neurodegeneration and Cognitive Deficits in Warriors with Mild Traumatic Brain Injury

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A159-A159
Author(s):  
K Werner ◽  
P Shahim ◽  
J Gill ◽  
R Nakase-Richardson ◽  
K Kenney
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Quality ◽  
Sleep Disorders ◽  
Cognitive Deficits ◽  
Neuronal Injury ◽  
Small Sample ◽  
Cross Sectional ◽  
Sleep Dysfunction ◽  
Obstructive Sleep

Abstract Introduction Increasing evidence links neurodegeneration to traumatic brain injury (TBI), and a separate body of literature links neurodegeneration to sleep dysfunction, implicating increased toxin production and decreased glymphatic clearance. Sleep disorders affect 50% of TBI patients, yet the sleep-neurodegeneration connection in these patients remains unexplored. We hypothesized that warfighters with TBI and sleep dysfunction would have increased neuronal injury, revealing potential mechanistic underpinnings for TBI outcomes. We measured plasma biomarkers, cognitive function and sleep surveys for correlation analysis. Methods In a retrospective cross-sectional study of warfighters (n=113 chronic mild TBI patients), the Pittsburgh sleep quality index (PSQI) was compared with amyloid β42 (Aβ42), neurofilament light (NFL), tau, and phospho-tau (threonine 181) isolated from plasma and exosomes. Executive function was tested with the categorical fluency test. Exosomes were precipitated from plasma. Proteins were measured with the Single Molecule Array (Quanterix). Linear models were adjusted for age, ApoE, and number of TBIs. Results Poor sleepers with TBI (PSQI>8) had elevated NFL compared to good sleepers in plasma (p=0.007) and exosomes (p=0.00017), and PSQI directly correlated with NFL (plasma: Beta=0.23, p=0.0079; exosomes: Beta=2.19, p=0.0013) stronger than any other marker of neurodegeneration. Poor sleepers also showed higher obstructive sleep apnea (OSA) risk compared to good sleepers by STOP-BANG scores (3.6, SD=1.6 vs 2.8, SD=1.74; p=0.0014) as well as decreased categorical fluency (20.7, SD=4.1) (18.3, SD=4.6, p=.0067). Plasma tau and Aβ42 also correlated with PSQI (Beta=0.64, p=0.028, and Beta=0.40, p=0.049 respectively). Conclusion This is the first reported data correlating markers of neuronal injury and cognitive deficits with sleep complaints and OSA risk in patients with TBI - possibly identifying treatable pathophysiological mediators of TBI neurodegeneration. Limitations include a small sample size, lack of objective sleep measures, and inability to establish directionality due to cross-sectional design. Prospective trials will be required to further explore our proposed hypothesis. If confirmed, these findings would call for targeting sleep disorders in the TBI population to mitigate risk of neurodegeneration. Support This work was supported by grant funding from: Department of Defense, Chronic Effects of Neurotrauma Consortium (CENC) Award W81XWH-13-2-0095 and Department of Veterans Affairs CENC Award I01 CX001135.

scholarly journals CPAP Improved Daytime Sleepiness and Memory Function in Patients With Obstructive Sleep Apnea Syndrome

2021 ◽  
Author(s):  
Ya-Ling Hong ◽  
Yu-Chih Shen ◽  
En-Ting Chang ◽  
Shu-Chin Kung
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Daytime Sleepiness ◽  
Memory Function ◽  
Demographic Data ◽  
Sleep Apnea Syndrome ◽  
Cpap Treatment ◽  
Obstructive Sleep ◽  
Cpap Compliance ◽  
Control Study

Abstract Objective: Obstructive sleep apnea (OSA) is a sleep disorder which results in daytime sleepiness and impaired memory function. The aim of this study was to investigate the effect of continuous positive airway pressure (CPAP) on sleepiness and memory function in OSA patients. We also investigated whether CPAP compliance impacted the effect of this treatment.Methods: The case-control study enrolled sixty-six patients with moderate to severe OSA subjects. All subjects completed a polysomnographic study, sleepiness questionnaires (the Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index), and four memory function tests (WM: working memory; PS: processing speed; LM: logical memory; FM: face memory).Results: Prior to CPAP treatment, no significant differences (p< 0.05) were noted in the demographic data, daytime sleepiness, or memory function between the two groups (with/without CPAP). However, OSA patients treated with CPAP for two months showed significant improvements in daytime sleepiness, PS, LM, and FM compared to those who did not receive CPAP treatment. A significant improvement in LM was observed in subjects who exhibited good compliance with CPAP treatment compared to those with poor compliance. Conclusions: In conclusion, CPAP treatment for two months improved daytime sleepiness and memory function in OSA patients. Patients exhibiting good CPAP compliance demonstrated greater improvements in daytime sleepiness and LM function.

scholarly journals ASSOCIATIONS OF GENERAL MENTAL HEALTH SYMPTOMS WITH SUBJECTIVE SLEEP QUALITY AND INDIVIDUAL DAYTIME SLEEPINESS

2019 ◽  
Vol 6 (4) ◽  
pp. 192-199
Author(s):  
R.S. Schierholz ◽  
I. Zavgorodniy ◽  
S. Darius ◽  
I. Böckelmann
Keyword(s):  
Mental Health ◽  
Sleep Quality ◽  
Daytime Sleepiness ◽  
General Health Questionnaire ◽  
Poor Sleep ◽  
Mental Health Symptoms ◽  
Subjective Sleep Quality ◽  
Health Symptoms ◽  
General Mental Health ◽  
Subjective Sleep

ASSOCIATIONS OF GENERAL MENTAL HEALTH SYMPTOMS WITH SUBJECTIVE SLEEP QUALITY AND INDIVIDUAL DAYTIME SLEEPINESS Schierholz RS, Zavgorodniy I., Darius S., Böckelmann I. Purpose: Sufficient sleep quality plays a significant role for long-term physical and mental health. The aim of this study was to examine the associations of general mental health symptoms with sleep quality and daytime sleepiness. Materials and Methods: A cross-sectional survey with 84 included participants (female: n = 42, male: n = 42) was conducted. General mental health symptoms were assessed using the 12-item General Health Questionnaire (GHQ-12), sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI), and daytime sleepiness was evaluated with the Epworth Sleepiness Scale (ESS). Statistical differences were calculated using two-sample t-test and Mann-Whitney U test. For correlation analyses Spearman’s rank correlation was used. Results: Subjects with poor sleep quality reached higher scores in the GHQ-12 and in the ESS than subjects with good sleep quality, but the difference regarding the ESS was not significant. Higher GHQ-12 scores were associated with higher PSQI scores but not with higher ESS scores. Conclusions: Major findings show strong evidence of an association between general mental health symptoms and sleep quality with poor sleepers having a more disturbed mental health than good sleepers. Further evidence of the interrelationship between subjective sleep quality and general mental health symptoms was found. Keywords: Mental health, Work ability, Stress, Sleep, Insomnia   Абстракт ЗВ’ЯЗОК ЗАГАЛЬНИХ СИМПТОМІВ ПСИХІЧНОГО ЗДОРОВ'Я З СУБ'ЄКТИВНОЮ ЯКІСТЮ СНУ ТАІНДИВІДУАЛЬНОЮ ДЕННОЮ СОНЛИВІСТЮ Робін Себастьян Шірхольц*, Ігор Завгородній, Сабіна Даріус, Ірина Беккельман Мета: Достатня якість сну відіграє важливу роль для тривалого фізичного та психічного здоров’я. Метою цьогодослідження було вивчення залежності загальних симптомів психічного здоров’я від якісті сну та денноїсонливості. Матеріали та методи: Було проведено перехресне опитування за участю 84 учасників (жінки: n = 42, чоловіки: n= 42). Загальні симптоми психічного здоров’я оцінювали за допомогою Анкети загального здоров’я (GHQ-12), яка містить 12 пунктів; якість сну оцінювали за допомогою Пітсбургського опитувальника якості сну (PSQI), а денну сонливість оцінювали за Шкалою сонливості Епворта (ESS). Статистичні відмінності розраховувались за допомогою двопробного t-тесту та U-тесту Манна-Вітні. Для кореляційного аналізу було використано рангову кореляцію Спірмена. Результати: Суб'єкти з низькою якістю сну показали більш високі показники у GHQ-12 та ESS, ніж суб'єкти із хорошою якістю сну, але різниця щодо ESS була несуттєвою. Більш високі показники GHQ-12 були пов'язані з більш високими показниками PSQI, але не з більш високими показниками ESS. Висновки: Основні результати виявляють вагомі докази зв'язку між загальними симптомами психічного здоров’я та якістю сну людей, які погано сплять, та людей з міцним сном. У людей з поганим сном більш виражені порушення психічного здоров’я. Були знайдені додаткові докази взаємозв'язку між суб'єктивною якістю сну та загальними симптомами психічного здоров'я. Ключові слова: Психічне здоров'я, працездатність, стрес, сон, безсоння    Абстракт СВЯЗЬ ОБЩИХ СИМПТОМОВ ПСИХИЧЕСКОГО ЗДОРОВЬЯ С СУБЪЕКТИВНЫМ КАЧЕСТВОМ СНА И ИНДИВИДУАЛЬНОЙ ДНЕВНОЙ СОНЛИВОСТЬЮ Робин Себастьян Ширхольц, Игорь Завгородний, Сабина Дариус, Ирина Беккельманн Цель: Достаточное качество сна играет важную роль для долгосрочного физического и психического здоровья. Целью данного исследования было изучение связи общих симптомов психического здоровья с качеством сна и дневной сонливостью. Материалы и методы. Было проведено перекрестное исследование с 84 участниками (женщины: n = 42, мужчины: n = 42). Общие симптомы психического здоровья оценивали с использованием Общего опросника здоровья (GHQ-12), содержащего 12 пунктов; качество сна оценивали с помощью Питтсбургского опросника качества сна (PSQI), а дневную сонливость оценивали по Шкале сонливости Эпворта (ESS). Статистические различия рассчитывали с использованием двухпробного t-теста и U-теста Манна-Уитни. Для корреляционного анализа была использована ранговая корреляция Спирмена. Результаты: Субъекты с плохим качеством сна показали более высокие баллы в GHQ-12 и в ESS, чем субъекты с хорошим качеством сна, но разница в отношении ESS не была значительной. Более высокие показатели GHQ-12 были связаны с более высокими показателями PSQI, но не с более высокими показателями ESS. Выводы: Основные результаты обнаруживают убедительные доказательства связи между общими симптомами психического здоровья и качеством сна людей, которые плохо спят, и людей с крепким сном. У людей с плохим сном более выражены нарушения психического здоровья. Были найдены дополнительные доказательства взаимосвязи между субъективным качеством сна и общими симптомами психического здоровья. Ключевые слова: психическое здоровье, трудоспособность, стресс, сон, бессонница

scholarly journals The effect of adherence with long-term PAP therapy on the psycho-emotional state of patients with obstructive sleep apnea syndrome

2020 ◽  
Vol 17 (2) ◽  
pp. 56-60
Author(s):  
E. M. Elfimova ◽  
O. O. Mikhailova ◽  
N. T. Khachatryan ◽  
I V Starostin ◽  
A. Yu. Litvin ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Quality ◽  
Obstructive Sleep Apnea Syndrome ◽  
Daytime Sleepiness ◽  
Sleep Apnea Syndrome ◽  
Good Adherence ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Aim. To assess the impact of adherence and effectiveness of long-term positive airway pressure therapy (PAP-therapy) on the clinical and psychological characteristics of patients with obstructive sleep apnea syndrome. Materials and methods. The study included 80 patients who were examined in the sleep apnea laboratory of the Myasnikov Institute of Clinical Cardiology of the National Medical Research Center for Cardiology and who have been on PAP-therapy for more than 12 months. The average age of the patients was 65.0 years [59.0; 71.0], body mass index 35.0 kg/m2 [31.0; 38.0], sleep apnea-hypopnea index (AHI) 39.5/h [31.0; 62.6]. The average duration of PAP therapy was 3.5 years [2.0; 6.0], while the minimum use was 1 year, the maximum 15 years. In the sample of patients who came in person, the percentage of days using PAP-therapy was 87.5% [62.0; 98.0] and the average usage time 6.3 hours [5.2; 7.3]. Results. On long-term PAP-therapy a persistent decrease in AHI was seen on average from 39.5/h [31.0; 62.6] to 2.7/h [1.2; 6.2], p=0,000. The criteria for good adherence to PAP-therapy (use 4 hours/night, more than 70% of nights) were met by the percentage of days of use by 67.5% of patients, the average time of use by 87.5% of patients. Both criteria for good adherence to PAP-therapy was met by 64.8% of patients. With long-term PAP-therapy, 71.7% of patients met the criteria of effectiveness (AHI5/h), AHI remained 5/h in 22.9% of patients and the average residual AHI was 10/h in 5.4% of patients. Correlation analysis showed associations between the PAP-therapy usage parameters and the severity of obstructive sleep apnea syndrome, and sleep quality: percentage of days of use and AHI (r=0.374, p=0.001), average time of use and PSQI (r=-0.438, p=0.000). Patients with a lower adherence to PAP-therapy (63.0% of days [22.0; 96.0] and 3.6 hours [2.4; 4.5] of use) did not differ in daytime sleepiness (ESS 5.0 points [2.0; 9.0] and 5.0 points [3.0; 8.0 ], p=0.891), but had a significantly lower quality of sleep (PSQI): 18.0 points [14.0; 20.0] versus 10.0 points [7.0; 18.0], p=0.004 compared with patients with high adherence to PAP-therapy (98.0% of the days [92.0; 99.0] and 7.9 hours [7.5; 8.2] of use). Conclusions. Patients with the higher adherence to PAP-therapy had significantly better sleep quality. But even the use of PAP-therapy for less than 4 hours is associated with a decrease in daytime sleepiness severity.

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