Executive dysfunction and learning effect after continuous positive airway pressure treatment in patients with obstructive sleep apnea syndrome.
OBJECTIVE
To assess the impact of continuous positive airway pressure (CPAP) treatment on executive dysfunction in patients with obstructive sleep apnea syndrome (OSAS).


METHODS
At baseline, 20 OSAS patients and 17 healthy controls underwent polysomnography and neuropsychological assessment focusing on executive functions. After at least 6 months of CPAP treatment, the patients returned for one more full-night polysomnography and neuropsychological control assessment, while the controls underwent a neuropsychological control assessment.


RESULTS
All patients and controls were working-age males. OSAS severity ranged from mild to severe. Before CPAP, patients showed poorer performance than controls in the copy of the Rey-Osterrieth Complex Figure Test, the Block Design, the Digit Symbol, the Trails B and the Intra-Extra Dimensional Set-Shifting task. Patients' executive performance showed no improvement after CPAP, and it remained poorer than the performance of controls. In addition, patients showed no learning effect in the executive tests, whereas the controls did.


CONCLUSIONS
Even long-term CPAP treatment does not seem to improve OSAS patients' mental set-shifting performance or their visuospatial organizational skills. In addition, OSAS patients have impaired learning effect in executive tests.
Saunamäki
Tiia
T
Department of Neurology and Rehabilitation, Tampere University Hospital, Tampere, Finland. tiia.saunamaki @ uta.fi
Himanen
Sari-Leena
SL
Polo
Olli
O
Jehkonen
Mervi
M
D000328:Adult; D000368:Aged; D003072:Cognition Disorders / Q000209:etiology*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007859:Learning Disabilities / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010349:Patient Compliance; D017286:Polysomnography / Q000379:methods; D011175:Positive-Pressure Respiration / Q000009:adverse effects*; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D018709:Statistics, Nonparametric