title: First night of CPAP: impact on memory consolidation attention and subjective experience.
abstract: OBJECTIVE
  Neurocognitive deficits are common and serious consequences of obstructive sleep apnea (OSA). Currently, the gold standard treatment is continuous positive air pressure (CPAP) therapy, although the clinical responses to this intervention can be variable. This study examined the effect of one night of CPAP therapy on sleep-dependent memory consolidation, attention, and vigilance as well as subjective experience.
  
  
  METHODS
  Fifteen healthy controls and 29 patients with obstructive sleep apnea of whom 14 underwent a full-night CPAP titration completed the psychomotor vigilance test (PVT) and motor sequence learning task (MST) in the evening and the morning after undergoing overnight polysomnography. All participants also completed subjective evaluations of sleep quality.
  
  
  RESULTS
  Participants with OSA showed significantly less overnight improvement on the MST compared to controls without OSA, independent of whether or not they had received CPAP treatment, while there was no significant difference between the untreated OSA and CPAP-treated patients. Within the OSA group, only those receiving CPAP exhibited faster reaction times on the PVT in the morning. Compared to untreated OSA patients, they also felt subjectively more rested and reported that they slept better.
  
  
  CONCLUSIONS
  Our results demonstrate an instant augmentation of subjective experience and, based on PVT results, attention and vigilance after one night of CPAP, but a lack of an effect on offline sleep-dependent motor memory consolidation. This dissociation may be explained by different brain structures underlying these processes, some of which might require longer continued adherence to CPAP to generate an effect.
authors.affiliation: Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Center for Sleep and Cognition, Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Division of Sleep Medicine, Sleep Disorders Program Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA. Electronic address: idjonlag@bidmc.harvard.edu.
authors.forename: Ina
authors.initials: I
authors.lastname: Djonlagic
authors.affiliation: Center for Sleep and Cognition, Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Division of Sleep Medicine, Sleep Disorders Program Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Mengshuang
authors.initials: M
authors.lastname: Guo
authors.affiliation: Center for Sleep and Cognition, Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Division of Sleep Medicine, Sleep Disorders Program Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Matteis
authors.affiliation: Division of Sleep Medicine, Sleep Disorders Program Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Carusona
authors.affiliation: Center for Sleep and Cognition, Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Stickgold
authors.affiliation: Division of Sleep Medicine, Sleep Disorders Program Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA; Division of Pulmonary and Critical Care, University of California San Diego, La Jolla, CA, USA.
authors.forename: Atul
authors.initials: A
authors.lastname: Malhotra
mesh_terms: D000328:Adult; D001288:Attention; D003072:Cognition Disorders / Q000523:psychology* / Q000628:therapy*; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D000069077:Memory Consolidation; D008875:Middle Aged; D017060:Patient Satisfaction; D017286:Polysomnography; D011597:Psychomotor Performance; D011930:Reaction Time; D012691:Serial Learning; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*
keywords: CPAP; Obstructive sleep apnea; PVT; Sleep-dependent memory