title: Neurobehavioral and autonomic alterations in adults with obstructive sleep apnea.
abstract: OBJECTIVE
  Obstructive sleep apnea (OSA) is associated with sympathetic hyperactivity, excessive nocturnal sweating, sleepiness, and neurobehavioral cognitive alterations. However, it is not well known if cognitive consequences of OSA are independent from autonomic alterations. Thus, we assessed the association between polysomnographic, autonomic, and cognitive tests performance in OSA patients.
  
  
  METHODS
  Fifty eight OSA patients (53 male) were administered with questionnaires assessing demographic, Epworth, Beck Depression Inventory, Syndrom Kurz test (SKT), Trail Making part B (TMT-B), and Frontal Assessment Battery (FAB) tests. Spectral analysis of heart rate variability (HRV) and night sweating symptoms (NSwS) score were used to assess autonomic function.
  
  
  RESULTS
  Global cognitive function (SKT) was normal in mild-moderate (M-OSA) and severe (S-OSA) patients. In S-OSA patients AHI was correlated with TMT-B (r = 0.30 P < 0.05) and with FAB (r = -0.31 P < 0.05). Oxygen desaturation was correlated with TMT-B (r = -0.45 P = < 0.001) and FAB (r = 0.29 P = < 0.05). Sympathetic overactivity was correlated with oxygen desaturation: HRV (r = -0.39 P < 0.05) and NSwS score (r = -0.49 P < 0.01), but HRV and NSwS score were not correlated with TMT-B and FAB.
  
  
  CONCLUSIONS
  Frontal cognitive dysfunction and predominance of sympathetic drive occur in OSA patients. Abnormal frontal cognitive function and sympathetic hyperactivity were related to oxygen desaturation, but not between each other. We conclude that neurobehavioral changes and autonomic imbalance in OSA patients take place independently from each other, suggesting different pathophysiological pathways.
authors.affiliation: Catedra de Neurología, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile. Electronic address: idiaquez@123.cl.
authors.forename: Juan
authors.initials: J
authors.lastname: Idiaquez
authors.affiliation: Catedra de Neurología, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile.
authors.forename: Irving
authors.initials: I
authors.lastname: Santos
authors.affiliation: Centro del Sueño, Departamento de Neurología, Facultad de Medicina Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Julia
authors.initials: J
authors.lastname: Santin
authors.affiliation: Laboratorio de Neurobiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile; Centro de Investigación Biomédica, Universidad Autónoma de Chile, Santiago, Chile.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Del Rio
authors.affiliation: Laboratorio de Neurobiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Iturriaga
mesh_terms: D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000209:etiology*; D003072:Cognition Disorders / Q000209:etiology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000503:physiopathology
keywords: Autonomic dysfunction; Cognitive dysfunction tests; Heart rate variability; Night sweating; Obstructive sleep apnea