Effects of Continuous Positive Airway Pressure on Neurocognitive Function in Obstructive Sleep Apnea Patients: The Apnea Positive Pressure Long-term Efficacy Study (APPLES)

Kushida, Clete A.; Nichols, Deborah A.; Holmes, Tyson H.; Quan, Stuart F.; Walsh, James K.; Gottlieb, Daniel J.; Simon, Richard; Guilleminault, Christian; White, David P.; Goodwin, James L.; Schweitzer, Paula K.; Leary, Eileen; Hyde, Pamela R.; Hirshkowitz, Max; Green, Sylvan; McEvoy, Linda K.; Chan, Cynthia; Gevins, Alan; Kay, Gary G.; Blöch, D.; Crabtree, Tami; Dement, William C.

doi:10.5665/sleep.2226

Cited by 356 publications

(278 citation statements)

References 44 publications

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“…In our sample, age and education explained most of the relationship between neurocognitive function and OSA in those older than 55 years. In accordance with our study, 36,37 education was the variable that mostly explained neurocognitive performance in the Apnea Positive Pressure Long-Term Efficacy Study, a multicenter randomized controlled trial of 1,204 adults (mean age 51 years) that evaluated continuous positive airway pressure and neurocognitive function in OSA. 37 The results of our study could be partly explained by our sample and methodologic differences.…”

Section: Figurementioning

confidence: 77%

Obstructive sleep apnea and neurocognitive function in a Hispanic/Latino population

et al. 2015

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Section: Figurementioning

confidence: 77%

Obstructive sleep apnea and neurocognitive function in a Hispanic/Latino population

et al. 2015

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“…Indeed, several studies investigating the effects of CPAP on glucose metabolism have reported lower average duration of sham-CPAP adherence as compared with therapeutic CPAP (20,21,29,30). A large randomized controlled multicenter trial (56), comparing the effects of therapeutic versus sham-CPAP, reported significantly lower adherence to sham-CPAP and a lower retention rate in the sham-CPAP group. Another large randomized controlled multicenter trial (57) also reported lower duration of sham-CPAP use as compared with active CPAP.…”

Section: Original Articlementioning

confidence: 99%

“…Second, in the study by Kushida and colleagues (56), about two-thirds of sham participants correctly guessed their treatment assignment, which raises the possibility of unblinding when sham-CPAP is used. In a recent randomized crossover trial of active versus sham-CPAP (58), when the patients were asked about their treatment experience before unblinding, most were able to identify the active CPAP as the more effective treatment.…”

Section: Original Articlementioning

confidence: 99%

Eight Hours of Nightly Continuous Positive Airway Pressure Treatment of Obstructive Sleep Apnea Improves Glucose Metabolism in Patients with Prediabetes. A Randomized Controlled Trial

Pamidi

Wroblewski²,

Stępień

et al. 2015

Am J Respir Crit Care Med

153

117

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Rationale: Although obstructive sleep apnea (OSA) is associated with impaired glucose tolerance and diabetes, it remains unclear whether OSA treatment with continuous positive airway pressure (CPAP) has metabolic benefits.Objectives: To determine the effect of 8-hour nightly CPAP treatment on glucose metabolism in individuals with prediabetes and OSA.Methods: In a randomized controlled parallel group study, 39 participants were randomly assigned to receive either 8-hour nightly CPAP (n = 26) or oral placebo (n = 13). Sleep was polysomnographically recorded in the laboratory on each night. CPAP adherence was ensured by continuous supervision. Participants continued their daily routine activities outside the laboratory. Glucose metabolism was assessed at baseline and after 2 weeks of assigned treatment using both the oral and intravenous glucose tolerance tests. The primary outcome was the overall glucose response as quantified by the area under the curve for glucose during 2-hour oral glucose tolerance testing. Secondary outcomes included fasting and 2-hour glucose and insulin, the area under the curves for insulin and insulin secretion, norepinephrine, insulin sensitivity, acute insulin response to glucose, and 24-hour blood pressure.

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“…[23][24][25][26] CPAP has shown mixed success in rectifying these impairments, 23,[26][27][28][29] although lingering posttreatment impairments are not uncommon. 23,30,31 In contrast, several large-scale studies in recent years have found cognitive impairment to be mild or nonsignificant in patients with OSA compared to control patients.…”

Section: ) (B)mentioning

confidence: 99%

Overnight Motor Skill Learning Outcomes in Obstructive Sleep Apnea: Effect of Continuous Positive Airway Pressure

Landry

O'Driscoll

Hamilton

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objective: 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). Methods: 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. Results: 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. Conclusions: 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. Keywords: cognitive impairment, consolidation, CPAP, learning, memory, motor skills, obstructive sleep apnea, OSA, sleep dependent Citation: Landry S, O'Driscoll DM, Hamilton GS, Conduit R. Overnight motor skill learning outcomes in obstructive sleep apnea: effect of continuous positive airway pressure.

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Effects of Continuous Positive Airway Pressure on Neurocognitive Function in Obstructive Sleep Apnea Patients: The Apnea Positive Pressure Long-term Efficacy Study (APPLES)

Cited by 356 publications

References 44 publications

Obstructive sleep apnea and neurocognitive function in a Hispanic/Latino population

Obstructive sleep apnea and neurocognitive function in a Hispanic/Latino population

Eight Hours of Nightly Continuous Positive Airway Pressure Treatment of Obstructive Sleep Apnea Improves Glucose Metabolism in Patients with Prediabetes. A Randomized Controlled Trial

Overnight Motor Skill Learning Outcomes in Obstructive Sleep Apnea: Effect of Continuous Positive Airway Pressure

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