Neuropsychological effects of 2-week continuous positive airway pressure treatment and supplemental oxygen in patients with obstructive sleep apnea: a randomized placebo-controlled study.
OBJECTIVE
To determine predictors of neuropsychological functioning in patients with obstructive sleep apnea (OSA) and whether treatment with 2-week continuous positive airway pressure (CPAP) or supplemental oxygen would improve cognitive functioning.


METHODS
Randomized placebo-controlled design.


METHODS
University-based clinical research center.


METHODS
Forty-six patients with untreated OSA.


METHODS
Two-week CPAP, supplemental oxygen, or placebo-CPAP.


RESULTS
Participants underwent polysomnography and completed a neuropsychological test battery before and after treatment. Prior to treatment, patients with OSA showed diffuse impairments, particularly in terms of speed of information processing, attention and working memory, executive functioning, learning and memory, as well as alertness and sustained attention. A global deficit score at baseline was positively correlated with percentage of stage 1 sleep (p = .049) only and was not correlated with obesity, daytime sleepiness, depression, fatigue, OSA severity, and the other polysomnography variables. The 3 treatment groups (therapeutic-CPAP, supplemental oxygen, and placebo-CPAP) were compared using repeated-measures analysis of variance (ANOVA). There was no significant Time x Treatment interaction for the global deficit score. When examining individual neuropsychological test scores, two thirds of them improved with time regardless of treatment, although only Digit Vigilance-Time (p = .020) showed significant improvement specific to CPAP treatment.


CONCLUSIONS
The present results suggest that Digit Vigilance-Time might be the most sensitive neuropsychological test for measuring the effects of the treatments. In general, 2 weeks of CPAP or oxygen-supplementation treatment was insufficient to show overall beneficial cognitive effects, as compared with placebo-CPAP. However, 2 weeks of CPAP treatment might be helpful in terms of speed of information processing, vigilance, or sustained attention and alertness.
Lim
Weonjeong
W
Department ofPsychiatry, University of California San Diego, La Jolla, CA 92093-0804, USA.
Bardwell
Wayne A
WA
Loredo
Jose S
JS
Kim
Eui-Joong
EJ
Ancoli-Israel
Sonia
S
Morgan
Erin E
EE
Heaton
Robert K
RK
Dimsdale
Joel E
JE
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001288:Attention; D003071:Cognition; D045422:Continuous Positive Airway Pressure / Q000379:methods* / Q000523:psychology*; D004311:Double-Blind Method; D006801:Humans; D007858:Learning; D008570:Memory, Short-Term; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010102:Oxygen Inhalation Therapy / Q000379:methods* / Q000523:psychology; D017286:Polysomnography / Q000379:methods; D011237:Predictive Value of Tests; D020181:Sleep Apnea, Obstructive / Q000523:psychology / Q000628:therapy*; D013997:Time Factors
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