Effects of continuous positive airway pressure on neurocognitive and neuropsychiatric function in obstructive sleep apnea

Dostálová, Veronika; Kolečkárová, Sandra; Kuška, Martin; Pretl, Martin; Bezdíček, Ondřej

doi:10.1111/jsr.12761

Cited by 17 publications

(14 citation statements)

References 33 publications

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“…A beneficial effect of short-term (2-3 months) treatment following CPAP on EDS (48, 50, 52-58) and depression (37,48,50,52,55,56,58) has been seen in many studies. Both somatic and affective/cognitive symptoms on the Beck Depression Inventory (BDI) improved equally after 3 months' CPAP treatment for OSA (37).…”

Section: Short-term (2-3 Months) Treatmentmentioning

confidence: 98%

Excessive Daytime Sleepiness in Depression and Obstructive Sleep Apnea: More Than Just an Overlapping Symptom

Zhang¹,

Zhang²,

Li³

et al. 2021

Front. Psychiatry

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Excessive daytime sleepiness (EDS) is a significant public health concern, with obstructive sleep apnea (OSA) being a common cause, and a particular relationship exists with the severity of depression. A literature search on OSA, depression, and EDS was performed in PubMed. The chosen evidence was limited to human studies. Available evidence was systematically reviewed to ascertain the association of EDS with depression and OSA according to the general population and some specific population subgroups. In addition, effectiveness of continuous positive airway pressure (CPAP) was analyzed as a standard therapy for improving EDS and depression in patients with OSA. In the general population, patients with OSA, and some other subpopulations, the review contributed to: (1) delineating the prevalence of EDS; (2) substantiating the relationship of EDS and depression; (3) presenting the relationship between EDS and OSA; and (4) revealing that the duration of CPAP is crucial for its therapeutic effects in improving EDS and depressive symptoms in patients with OSA.

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Section: Short-term (2-3 Months) Treatmentmentioning

confidence: 98%

Excessive Daytime Sleepiness in Depression and Obstructive Sleep Apnea: More Than Just an Overlapping Symptom

Zhang¹,

Zhang²,

Li³

et al. 2021

Front. Psychiatry

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“…The purpose of this study was to assess the effects of nocturnal CPAP breathing on the emotional status and cognitive performance in OSA patients. A total of 21 articles were reviewed for this study [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. To find, screen, and choose relevant publications, we used PubMed, PubMed Central (PMC), and MEDLINE as our primary databases.…”

Section: Reviewmentioning

confidence: 99%

“…We ensured to include studies that measured the effect of CPAP on depression and anxiety by using any one of the validated scales such as the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), Hospital Anxiety and Depression Scale (HADS), or Hamilton Depression Scale (HAM-D). Five observational studies found that CPAP improves OSA's psychological complaints when used over three months [20][21][22][23][24]. One study even finds it to be more effective in improving depressive symptoms than surgical treatment [20].…”

Section: Effect Of Cpap On Depression Anxiety and Quality Of Life In Osa Patientsmentioning

confidence: 99%

“…Similarly, before receiving therapy with CPAP, Sanchez et al observed many of their study participants complaining about getting fired from their work, unable to drive, and experiencing difficulties relating to their sexual life, primarily due to night-time sleep fragmentation leading to daytime tiredness [ 22 ]. Using the Epworth Sleepiness Scale, Dostálová et al concluded that the positive effect of CPAP is mostly attributed to a drop in AHI during sleep, which results in an increase in daytime sleepiness and a decline in depressive symptoms [ 23 ].…”

Section: Reviewmentioning

confidence: 99%

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An Updated Review on the Relationship of Depressive Symptoms in Obstructive Sleep Apnea and Continuous Positive Airway Pressure

Aftab

Anthony

Rahmat

et al. 2021

Cureus

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Obstructive sleep apnea (OSA) is a common sleep disorder occurring across all age groups, gender, and is multifactorial. The episodic decrease in airflow during sleep results in hypoxia and hypercapnia over time, resulting in morning headache, systemic and pulmonary hypertension, and polycythemia. Fragmentation of sleep at night-time cause daytime somnolence, fatigue, memory problems, and mood symptoms such as depression and anxiety. These secondary mood symptoms could be easily missed by healthcare providers as the primary disorder resulting in unnecessary anti-depressants' prescription. This study investigates the effect of continuous airway pressure (CPAP) on depressive symptoms of OSA. We used PubMed, PubMed Central (PMC), and MEDLINE for data collection. We used OSA, depression, anxiety, mood symptoms, psychological symptoms, and CPAP as the keywords, both alone and in combination. The search ended on November 5, 2020, and it was limited to the year 2010 until the day of the search. However, a few of the papers published earlier than 2010 were also included to have better insight into some aspects of the topic. We included articles measuring the impact of CPAP on mood symptoms using any one of the validated scales, such as the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), Hospital Anxiety and Depression Scale (HADS), or Hamilton Depression Scale (HAM-D). Our initial searches yielded 131 articles. Twenty-one of the 131 papers satisfied the review's criteria. Four studies out of 21 revealed no improvement in OSA-related mood symptoms with CPAP therapy, whereas the others reported beneficial effects on mood, daytime sleepiness, cognition, and patient quality of life.

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“…Validated modifiable risk factors can be used to mitigate the progression of age-related cognitive decline. For instance, OSAS is associated with Alzheimer's disease biomarker accumulation (Bubu et al, 2019) and can be treated with continuous positive airway pressure (CPAP) (Marshall et al, 2006;Cooke et al, 2009;Kylstra et al, 2013;Richards et al, 2019), which improves cognitive function in patients suffering from Alzheimer's disease, although its effect on pathological progression remains unknown (Ancoli-Israel et al, 2008;Troussiere et al, 2014;Dostalova et al, 2019). The purpose of this exploratory study was therefore to (a) assess the prevalence of each form of SAS in a cohort of elderly patients (>70 years old) admitted to our geriatric unit for non-acute reasons, and (b) investigate the independent relation between sleep apnea and cognitive performance, measured using validated tests, including the Mini Mental-State Exam (MMSE), the Mattis Dementia rating Scale (MDRS) and the Stroop test, and competing against known risk factors for cognitive impairment.…”

Section: Introductionmentioning

confidence: 99%

Sleep Apnea Syndrome in an Elderly Population Admitted to a Geriatric Unit: Prevalence and Effect on Cognitive Function

Attier-Zmudka

Sérot

Valluy

et al. 2020

Front. Aging Neurosci.

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Background: Sleep apnea leads to cognitive impairment in older patients, but its association with neurodegeneration remains controversial, and most studies do not distinguish between the more common obstructive form (OSAS) and the rarer central form (CSAS). Objective: The purpose of this study was to assess the prevalence of the different forms of sleep apnea in a cohort of cognitively impaired elderly patients (>70 years) and to investigate their associations with cognitive deficit, weighted against known risk factors for neurodegeneration. Methods: Overnight polygraphy was performed for 76 consecutive patients admitted to our geriatric unit. Their cognitive function was assessed using the Mini Mental-State Exam (MMSE), Mattis Dementia Rating Scale (MDRS) and Stroop test. Multivariable analyses were performed to determine associations between cognitive function and independent variables describing demographics, sleep apnea measures, and cardiovascular risk factors. Results: The cohort comprised 58 women and 18 men aged a mean of 84 years (range, 73-96). Sleep apnea syndrome (SAS) was diagnosed in 48 patients (63%), of which 31 (41%) with OSAS and 17 (22%) with CSAS. Multivariable regression analysis revealed that MDRS was lower in patients with OSAS (β = −10.03, p = 0.018), that Stroop Colors and Words delays increased with AHI (β = 0.17, p = 0.030 and β = 0.31, p = 0.047) and that that Stroop Interference delay was higher in patients with CSAS (β = 24.45, p = 0.002). Conclusion: Sleep apnea is thus highly prevalent in elderly patients with cognitive impairment. OSAS was associated with lower general cognitive function, while CSAS was only associated with increased Stroop Interference delays. Elderly patients with cognitive deficit could benefit from sleep apnea screening and treatment.

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Effects of continuous positive airway pressure on neurocognitive and neuropsychiatric function in obstructive sleep apnea

Cited by 17 publications

References 33 publications

Excessive Daytime Sleepiness in Depression and Obstructive Sleep Apnea: More Than Just an Overlapping Symptom

Excessive Daytime Sleepiness in Depression and Obstructive Sleep Apnea: More Than Just an Overlapping Symptom

An Updated Review on the Relationship of Depressive Symptoms in Obstructive Sleep Apnea and Continuous Positive Airway Pressure

Sleep Apnea Syndrome in an Elderly Population Admitted to a Geriatric Unit: Prevalence and Effect on Cognitive Function

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