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Moderate to severe neuropsychological sequelae of out-of-hospital cardiac arrest are still present in approximately one half of the survivors at 1 year and may be permanent. There seems to be no excess of increased disability in the subgroup of patients with delayed advanced life support. Nimodipine failed to show any effect on the cognitive functions tested.

SUMMARY Among patients with obstructive sleep apnea syndrome (OSAS), impairment of cognitive function, i.e. deficits in memory, attention, and visuconstructive abilities are common. We applied different forms of treatment for patients with newly diagnosed OSAS in a randomized study with a one-year follow-up. Patients with BMI > 40 kg/ m 2 were excluded. After the initial diagnostic work-up, male patients were considered to be candidates for either nasal continuous airway pressure (nCPAP) (27 patients) or surgical treatment (uvulopalatopharyngoplasty with or without mandibular osteotomy) (23 patients). Within the groups, the patients were then randomized to active treatment (nCPAP/surgery) or to conservative management. Cognitive function and severity of OSAS were assessed prior to treatment and 3 and 12 months later. At 12 months, all patients on nCPAP had a normal ODI 4 index (< 10), and were significantly less somnolent than their controls; 3/11 of the surgically treated patients had a normal ODI 4 index. Daytime somnolence was significantly less severe in the surgically treated patients than in their controls. Cognitive function did not correlate importantly with daytime sleepiness or severity of OSAS; the best Pearson pairwise correlation coefficient was between ODI 4 and the Bourdon-Wiersma (r=0.36). Success in treatment of OSAS did not affect neuropsychological outcome. We concluded that the standard cognitive test battery is insufficiently sensitive to identify positive changes in patients with OSAS, especially among those with a high level of overall mental functioning.

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The association of snoring with some cardiovascular risk factors was studied cross-sectionally by a postal survey among 3750 males aged 40-59 years. In univariate analyses, snoring associated statistically significantly (P < 0.01) with hypertension, smoking, obesity, heavy alcohol use, physical inactivity, dyspnoea, hostility and morning tiredness. In a multiple logistic regression model adjusted by age, snoring associated significantly with smoking, obesity, physical inactivity, hostility and morning tiredness. When smoking was excluded from the multivariate model, alcohol use was also associated significantly with snoring. The association of snoring with smoking, and with obesity seemed to be almost independent from other studied correlates of snoring. Our results indicate that in further studies on predictive value of snoring with regard to coronary heart disease and stroke, the associations of snoring with hypertension, smoking, obesity, heavy alcohol use, physical inactivity and hostility have to be considered, as these risk characteristics may cause confounding effects.

Once good outcome after cardiac arrest is achieved, it can be maintained for more than 10 years.