title: Overnight Motor Skill Learning Outcomes in Obstructive Sleep Apnea: Effect of Continuous Positive Airway Pressure.
abstract: To determine the effectiveness of continuous positive airway pressure (CPAP) therapy in alleviating known impairments in the overnight consolidation of motor skill learning in patients with obstructive sleep apnea (OSA).
  
  
  
  Twenty-five patients with untreated moderate-severe OSA, 13 first-night CPAP users, 17 compliant CPAP users, and 14 healthy control patients were trained on a motor sequence learning task (Sequential Finger Tapping Task, SFTT) and were subsequently tested prior to and after polysomnographic recorded sleep. Measures of subjective sleepiness (Karolinska Sleepiness Scale) and sustained attention (Psychomotor Vigilance Task) were also completed before and after sleep.
  
  
  
  Typical analyses of overnight improvement on the SFTT show significantly greater overnight gains in motor task speed in controls (+11.6 ± 4.7%, p = 0.007) and compliant CPAP users (+8.9 ± 4.3%, p = 0.008) compared to patients with OSA (-4.86 ± 4.5%). Additional analyses suggest that these improvements in motor performance occurred prior to the sleep episode, as all groups significantly improved (15% to 22%) over a 10-min presleep rest period. Thereafter, performance in all groups significantly deteriorated over sleep (6% to 16%) with trends toward patients with OSA showing greater losses in performance compared to control patients and compliant CPAP users. No between-group differences in subjective sleepiness and sustained attention were found presleep and postsleep.
  
  
  
  The current data suggest impairments in overnight motor learning in patients with OSA may be a combination of deficient stabilization of memory over a sleep episode as well as increased vulnerability to time on task fatigue effects. Compliant CPAP usage possibly offsets both of these impediments to learning outcomes by improving both sleep quality and subsequent daytime function.
authors.affiliation: School of Psychological Sciences, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Victoria, Australia.
authors.forename: Shane
authors.initials: S
authors.lastname: Landry
authors.affiliation: Department of Respiratory and Sleep Medicine, Eastern Health, Victoria, Australia.|Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Australia.|Monash Lung and Sleep, Monash Health, Clayton, Australia.
authors.forename: Denise M
authors.initials: DM
authors.lastname: O'Driscoll
authors.affiliation: Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Australia.|Monash Lung and Sleep, Monash Health, Clayton, Australia.
authors.forename: Garun S
authors.initials: GS
authors.lastname: Hamilton
authors.affiliation: School of Health Sciences, Royal Melbourne Institute of Technology, Melbourne, Victoria, Australia.
authors.forename: Russell
authors.initials: R
authors.lastname: Conduit
mesh_terms: D060825:Cognitive Dysfunction / Q000209:etiology* / Q000503:physiopathology; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D006801:Humans; D007858:Learning / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology*; D017286:Polysomnography; D011930:Reaction Time / Q000502:physiology; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000628:therapy*; D013647:Task Performance and Analysis
keywords: CPAP; OSA; cognitive impairment; consolidation; learning; memory; motor skills; obstructive sleep apnea; sleep dependent