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Titolo:
Cognitive function in the sleep apnea/hypopnea syndrome (SAHS)
Autore:
Engleman, HM; Kingshott, RN; Martin, SE; Douglas, NJ;
Indirizzi:
Univ Edinburgh, Resp Med Unit, Edinburgh EH8 9YL, Midlothian, Scotland Univ Edinburgh Edinburgh Midlothian Scotland EH8 9YL Midlothian, Scotland
Titolo Testata:
SLEEP
, volume: 23, anno: 2000, supplemento:, 4
pagine: S102 - S108
SICI:
0161-8105(20000615)23:<S102:CFITSA>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
POSITIVE AIRWAY PRESSURE; APNEA HYPOPNEA SYNDROME; DAYTIME FUNCTION; APNOEA/HYPOPNOEA SYNDROME; NEUROPSYCHOLOGICAL DEFICITS; CPAP THERAPY; PERFORMANCE; ACCIDENTS; TRIAL;
Keywords:
sleep apnea/hypopnea syndrome; cognitive performance; psychomotor performance; CPAP;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
30
Recensione:
Indirizzi per estratti:
Indirizzo: Engleman, HM Royal Infirm, Ward 48, Edinburgh Sleep Ctr, Lauriston Pl, Edinburgh EH3 9YW, Midlothian, Scotland Royal Infirm Lauriston Pl Edinburgh Midlothian Scotland EH3 9YW
Citazione:
H.M. Engleman et al., "Cognitive function in the sleep apnea/hypopnea syndrome (SAHS)", SLEEP, 23, 2000, pp. S102-S108

Abstract

The magnitude, determinants and reversibility of cognitive deficits associated with the sleep apnea/hypopnea syndrome (SAHS) are of clinical and research interest. A quantitative overview of impairment effect sizes (ESs) from case-control studies of cognitive performance in SAHS suggests that deficits broadly worsen with disease severity, with large average values for attentional (ES approximate to 1.0 SD units) and executive (ES approximate to 0.9 SD units) cognitive scores, and moderate values for memory-related (ES approximate to 0.6 SD units) performance scores. A study of determinants ofcognitive outcomes conducted in 150 patients with SAHS (AHI 5+ and greaterthan or equal to 2 symptoms) showed significant but weak associations between a cognitive 'intellectual ability' component score (CS) and both AHI (r=-0.14) and minimum oxygen saturation (r=0.15), linking increasing disease severity with poorer performance. A somewhat stronger correlation between acognitive 'response slowing' CS and a 'wakefulness' CS was observed (r=-0.34). That sleepiness as well as hypoxemia might contribute to cognitive deficit has also been suggested by experimental sleep fragmentation in normals, producing small to moderate impairments (average ES approximate to 0.3 SDunits) in attention-biased scores. The reversibility of attentional cognitive deficits has been investigated through a meta-analysis of randomized placebo-controlled crossover studies of CPAP treatment, involving 98 SAHS patients (AHI 5+ and greater than or equal to 2 symptoms). While cognitive outcomes showed at least trends towards better performance on CPAP than on placebo (p less than or equal to 0.1), the ESs of cognitive enhancements following CPAP were small (average ES approximate to 0.2 SD units). This may be due either to the relatively mild study population, suboptimal CPAP use or to an irreversible component in cognitive impairment in SAHS.

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Documento generato il 23/01/20 alle ore 03:36:48