Skip to main content
NCBI home page
Thorax logoLink to Thorax
. 1993 Sep;48(9):911–914. doi: 10.1136/thx.48.9.911

Daytime sleepiness, cognitive performance and mood after continuous positive airway pressure for the sleep apnoea/hypopnoea syndrome.

H M Engleman 1, K E Cheshire 1, I J Deary 1, N J Douglas 1
PMCID: PMC464776  PMID: 8236074

Abstract

BACKGROUND--Patients with the sleep apnoea/hypopnoea syndrome often receive continuous positive airway pressure to improve their symptoms and daytime performance, yet objective evidence of the effect of this treatment on cognitive performance is lacking. METHODS--A prospective parallel group study was performed comparing the change in objective daytime sleepiness as assessed by multiple sleep latency, cognitive function, and mood in 21 patients (mean (SE) number of apnoeas and hypopnoeas/hour 57 (6)) who received continuous positive airway pressure for three months and 16 patients (49(6) apnoeas and hypopnoeas/hour) who received conservative treatment for a similar period. RESULTS--Both groups showed significant within group changes in cognitive function between baseline and three months, but when comparisons were made between groups the only significant difference was a greater improvement in multiple sleep latency with continuous positive airway pressure. However, the improvement in sleep latency with continuous positive airway pressure was relatively small (3.5 (0.5) to 5.6 (0.7) min). The group treated with continuous positive airway pressure was divided into those who complied well with treatment (> 4.5 hours/night) and those who did not. Those who complied well (n = 14) showed significant improvement in mean sleep latency and also in depression score compared with the controls but no greater improvement in cognitive function. CONCLUSION--This study confirms significant improvements in objective sleepiness and mood with continuous positive airway pressure, but shows no evidence of major improvements in cognitive function.

Full text

PDF
911

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Carskadon M. A., Dement W. C., Mitler M. M., Roth T., Westbrook P. R., Keenan S. Guidelines for the multiple sleep latency test (MSLT): a standard measure of sleepiness. Sleep. 1986 Dec;9(4):519–524. doi: 10.1093/sleep/9.4.519. [DOI] [PubMed] [Google Scholar]
  2. Cheshire K., Engleman H., Deary I., Shapiro C., Douglas N. J. Factors impairing daytime performance in patients with sleep apnea/hypopnea syndrome. Arch Intern Med. 1992 Mar;152(3):538–541. [PubMed] [Google Scholar]
  3. Crawford J. R., Stewart L. E., Moore J. W. Demonstration of savings on the AVLT and development of a parallel form. J Clin Exp Neuropsychol. 1989 Dec;11(6):975–981. doi: 10.1080/01688638908400950. [DOI] [PubMed] [Google Scholar]
  4. Derderian S. S., Bridenbaugh R. H., Rajagopal K. R. Neuropsychologic symptoms in obstructive sleep apnea improve after treatment with nasal continuous positive airway pressure. Chest. 1988 Nov;94(5):1023–1027. doi: 10.1378/chest.94.5.1023. [DOI] [PubMed] [Google Scholar]
  5. Douglas N. J., Thomas S., Jan M. A. Clinical value of polysomnography. Lancet. 1992 Feb 8;339(8789):347–350. doi: 10.1016/0140-6736(92)91660-z. [DOI] [PubMed] [Google Scholar]
  6. Findley L. J., Barth J. T., Powers D. C., Wilhoit S. C., Boyd D. G., Suratt P. M. Cognitive impairment in patients with obstructive sleep apnea and associated hypoxemia. Chest. 1986 Nov;90(5):686–690. doi: 10.1378/chest.90.5.686. [DOI] [PubMed] [Google Scholar]
  7. Findley L. J., Fabrizio M. J., Knight H., Norcross B. B., LaForte A. J., Suratt P. M. Driving simulator performance in patients with sleep apnea. Am Rev Respir Dis. 1989 Aug;140(2):529–530. doi: 10.1164/ajrccm/140.2.529. [DOI] [PubMed] [Google Scholar]
  8. Fletcher E. C., Luckett R. A. The effect of positive reinforcement on hourly compliance in nasal continuous positive airway pressure users with obstructive sleep apnea. Am Rev Respir Dis. 1991 May;143(5 Pt 1):936–941. doi: 10.1164/ajrccm/143.5_Pt_1.936. [DOI] [PubMed] [Google Scholar]
  9. Gould G. A., Whyte K. F., Rhind G. B., Airlie M. A., Catterall J. R., Shapiro C. M., Douglas N. J. The sleep hypopnea syndrome. Am Rev Respir Dis. 1988 Apr;137(4):895–898. doi: 10.1164/ajrccm/137.4.895. [DOI] [PubMed] [Google Scholar]
  10. Greenberg G. D., Watson R. K., Deptula D. Neuropsychological dysfunction in sleep apnea. Sleep. 1987 Jun;10(3):254–262. doi: 10.1093/sleep/10.3.254. [DOI] [PubMed] [Google Scholar]
  11. Lamphere J., Roehrs T., Wittig R., Zorick F., Conway W. A., Roth T. Recovery of alertness after CPAP in apnea. Chest. 1989 Dec;96(6):1364–1367. doi: 10.1378/chest.96.6.1364. [DOI] [PubMed] [Google Scholar]
  12. Sanders M. H. Nasal CPAP effect on patterns of sleep apnea. Chest. 1984 Dec;86(6):839–844. doi: 10.1378/chest.86.6.839. [DOI] [PubMed] [Google Scholar]
  13. Sangal R. B., Thomas L., Mitler M. M. Disorders of excessive sleepiness. Treatment improves ability to stay awake but does not reduce sleepiness. Chest. 1992 Sep;102(3):699–703. doi: 10.1378/chest.102.3.699. [DOI] [PubMed] [Google Scholar]
  14. Sullivan C. E., Issa F. G., Berthon-Jones M., Eves L. Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares. Lancet. 1981 Apr 18;1(8225):862–865. doi: 10.1016/s0140-6736(81)92140-1. [DOI] [PubMed] [Google Scholar]
  15. Thorpy M. J. The clinical use of the Multiple Sleep Latency Test. The Standards of Practice Committee of the American Sleep Disorders Association. Sleep. 1992 Jun;15(3):268–276. doi: 10.1093/sleep/15.3.268. [DOI] [PubMed] [Google Scholar]
  16. Walsleben J. A., Squires N. K., Rothenberger V. L. Auditory event-related potentials and brain dysfunction in sleep apnea. Electroencephalogr Clin Neurophysiol. 1989 Jul-Aug;74(4):297–311. doi: 10.1016/0168-5597(89)90060-9. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES