Effects of CPAP therapy on cognitive and psychomotor performances in patients with severe obstructive sleep apnea: a prospective 1-year study
- 141 Downloads
We prospectively investigated the effects of continuous positive airway pressure (CPAP) on long-term cognitive and psychomotor performances, and excessive daytime sleepiness in severe obstructive sleep apnea (OSA) patients.
A total of 40 patients were recruited and 23 patients with severe OSA fully completed the study protocol to investigate the effects of CPAP therapy on psychomotor performance at 1, 3, and 6 months and 1 year following initiation of the therapy. Psychomotor CRD-series tests measuring reaction times of light stimulus perception, solving simple arithmetic operations, and complex psychomotor limb coordination, were used in this study. The data collected following CPAP therapy were compared to baseline values prior to the CPAP treatment for each patient.
All of the measured variables improved following CPAP treatment. However, the most pronounced effect was observed in improvement of reaction times to complex psychomotor limb coordination test (p < 0.05). Self-reported evaluation of excessive daytime sleepiness measured by Epworth Sleepiness Scale (ESS) showed significant decrease from 10.0 ± 1.1 before to 3.5 ± 0.5 (p < 0.001), after 1 year on CPAP therapy.
The CPAP therapy improved cognitive and psychomotor performance on CRD-series tests with the most significant improvement observed in complex psychomotor limb coordination of severe OSA patients.
KeywordsObstructive sleep apnea Continuous positive airway pressure Cognitive Psychomotor Sleepiness
The authors wish to thank Jelena Baricevic and Dijana Radanovic bacc. med. techn. for their technical assistance.
Croatian Science Foundation provided financial support in the form of grant #IP-11-2013-5935 funding.
The sponsor had no role in the design or conduct of this research.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Ethics Committee of the University of Split School of Medicine (USSM)) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.American Academy of Sleep Medicine Aiawt, SOCIETY ESR, RESEARCH JSOS, SOCIETY LAS (2014) International Classification of Sleep Disorders – Third Edition (ICSD-3)Google Scholar
- 8.Knoepke CAM (2009) Proposed mechanism of cognitive dysfunction in obstructive sleep apnea. Primary Psychiatry 16(10):51–66Google Scholar
- 9.Verstraeten E, Cluydts R, Pevernagie D, Hoffmann G (2004) Executive function in sleep apnea: controlling for attentional capacity in assessing executive attention. Sleep 27(4):685–693Google Scholar
- 13.Karanovic N, Carev M, Kardum G, Pecotic R, Valic M, Karanovic S, Ujevic A, Dogas Z (2009) The impact of a single 24 h working day on cognitive and psychomotor performance in staff anaesthesiologists. Eur J Anaesthesiol 26(10):825–832. https://doi.org/10.1097/EJA.0b013e32832bb6e4 CrossRefGoogle Scholar
- 14.Petri NM, Dropulic N, Kardum G (2006) Effects of voluntary fluid intake deprivation on mental and psychomotor performance. Croat Med J 47(6):855–861Google Scholar
- 16.Galic T, Bozic J, Pecotic R, Ivkovic N, Valic M, Dogas Z (2016) Improvement of cognitive and psychomotor performance in patients with mild to moderate obstructive sleep apnea treated with mandibular advancement device: a prospective 1-year study. J Clin Sleep Med : JCSM : Off Publ Am Acad Sleep Med 12(2):177–186. https://doi.org/10.5664/jcsm.5480 Google Scholar
- 17.Epstein LJ, Kristo D, Strollo PJ, Jr., Friedman N, Malhotra A, Patil SP, Ramar K, Rogers R, Schwab RJ, Weaver EM, Weinstein MD (2009) Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 5 (3):263–276Google Scholar
- 19.Kushida CA, Littner MR, Morgenthaler T, Alessi CA, Bailey D, Coleman J, Jr., Friedman L, Hirshkowitz M, Kapen S, Kramer M, Lee-Chiong T, Loube DL, Owens J, Pancer JP, Wise M (2005) Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep 28 (4):499–521Google Scholar
- 20.Drenovac M (2001) An analysis of some attributes of the dynamics of mental processing. Rev Psychol 8:61–67Google Scholar
- 21.Quan SF, Wright R, Baldwin CM, Kaemingk KL, Goodwin JL, Kuo TF, Kaszniak A, Boland LL, Caccappolo E, Bootzin RR (2006) Obstructive sleep apnea-hypopnea and neurocognitive functioning in the sleep heart health study. Sleep Med 7(6):498–507. https://doi.org/10.1016/j.sleep.2006.02.005 CrossRefGoogle Scholar
- 28.Kushida CA, Nichols DA, Holmes TH, Quan SF, Walsh JK, Gottlieb DJ, Simon RD, Jr., Guilleminault C, White DP, Goodwin JL, Schweitzer PK, Leary EB, Hyde PR, Hirshkowitz M, Green S, McEvoy LK, Chan C, Gevins A, Kay GG, Bloch DA, Crabtree T, Dement WC (2012) Effects of continuous positive airway pressure on neurocognitive function in obstructive sleep apnea patients: the apnea positive pressure long-term efficacy study (APPLES). Sleep 35 (12):1593–1602. doi: https://doi.org/10.5665/sleep.2226