Effects of surgery for obstructive sleep apnea on cognitive function and driving performance

Alkan, Uri; Nachalon, Yuval; Weiss, Penina; Ritter, Amit; Feinmesser, Raphael; Gilat, Hanna; Bachar, Gideon

doi:10.1007/s11325-020-02285-w

Cited by 7 publications

(5 citation statements)

References 26 publications

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“…ICP and cognitive and psychological long-term follow-up data have demonstrated statistically significant improvement after early surgery. [46][47][48][49] The effect of midface hypoplasia associated with faciocraniosynostosis on the brain is underestimated, as the effect on ICP is difficult to gauge and correlate. Chronic sleep apnea, either central or obstructive, leads to impaired cognitive function and should be explored in the preoperative workup.…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted frontofacial correction in very young children with craniofacial dysostosis syndromes: a technical note and early functional outcome

Udayakumaran

Krishnadas

Subash

2022

Neurosurgical Focus

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OBJECTIVE In this study, the authors aimed to 1) retrospectively analyze the early functional outcomes in a cohort of very young children with craniofacial dysostoses who underwent robot-assisted frontofacial advancement (RAFFA) or robot-assisted midface distraction (RAMD), and 2) analyze the utility of robotic assistance in improving the accuracy and safety of performing transfacial pin insertion for RAFFA or RAMD. METHODS A retrospective analysis of a cohort of 18 children (age range 1–42 months at presentation), who underwent RAFFA or RAMD from February 2015 to February 2021 in the craniofacial unit at Amrita Institute of Medical Sciences and Research Centre in Kochi, India, was performed. Inclusion criteria were patients who had undergone RAFFA in a single stage or RAMD where the cranial vault had been addressed earlier, had been addressed on follow-up, or had not been addressed and had follow-up of at least 6 months. RESULTS Overall, 18 children with syndromic craniosynostosis underwent LeFort level III midface distraction, with or without RAFFA, from February 2015 to February 2021 at a single center in India. The patients’ ages ranged from 6 to 47 months at the time of the procedure. All patients had significant obstructive sleep apnea (OSA), significant ocular issues, and disturbed sleep as determined by the authors’ preoperative protocol. Clinically significant intracranial pressure issues were present in 17 patients. None of the patients had injury due to the transfacial pin trajectory such as globe injury, damage to the tooth buds, or the loss of purchase during the active distraction phase. The mean distraction achieved was 23 mm (range 18–30 mm) (n = 16/18). Of the 18 patients, 10 (56%) had an excellent outcome and 6 (33%) had a satisfactory outcome. In all cases, the degree of OSA had significantly reduced after surgery. Eye closure improved in all patients, and complete closure was seen in 11 patients. On follow-up, the functional gain remained in 14 of 16 patients at the final follow-up visit. The distraction results were stable during the follow-up period (mean 36 months [range 6–72 months]). CONCLUSIONS The early RAFFA and RAMD protocols investigated in this study gave a significant functional advantage in very young patients with craniofacial dysostoses. The results have demonstrated the accuracy and safety of robotic assistance in performing transfacial pin insertion for RAFFA or RAMD.

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Section: Discussionmentioning

confidence: 99%

Robot-assisted frontofacial correction in very young children with craniofacial dysostosis syndromes: a technical note and early functional outcome

Udayakumaran

Krishnadas

Subash

2022

Neurosurgical Focus

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“…A study with 32 participants showed a positive effect of uvulopalatopharyngoplasty on attention three to six months postoperatively 133 .…”

Section: Obstructive Sleep Apnea Syndrome and Cognitionmentioning

confidence: 99%

“…Unter der Therapie mit UKPS konnte eine Verbesserung depressiver Symptome erreicht werden 129 . Eine Studie mit 32 Teilnehmern zeigte einen positiven Effekt einer Uvulopalatopharyngoplastik auf die Aufmerksamkeit 3–6 Monate postoperativ 133 .…”

Section: 42 Nicht-pap-therapieunclassified

Obstruktive Schlafapnoe – Einfluss auf kardiovaskuläres System und Kognition

Schneider¹

2023

Laryngorhinootologie

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ZusammenfassungKardiovaskuläre und kognitive Erkrankungen sind ebenso wie die obstruktive Schlafapnoe sehr häufige Krankheiten mit einer erheblichen Beeinträchtigung der Lebensqualität und einer deutlichen sozioökonomischen Bedeutung. Die Auswirkungen einer unbehandelten obstruktiven Schlafapnoe (OSA) auf das kardiovaskuläre und kognitive Erkrankungsrisiko und die Therapieeffekte einer OSA sind für die meisten kardiovaskulären und kognitiven Folgeerkrankungen wissenschaftlich nachgewiesen. Für die klinische Praxis besteht ein deutlicher Bedarf nach mehr Interdisziplinarität. Aus schlafmedizinischer Sicht müssen bei der Therapieindikation das individuelle kardiovaskuläre und kognitive Risiko berücksichtigt und kognitive Erkrankungen bei der Beurteilung der Therapieintoleranz und residuellen Symptomatik beachtet werden. Aus internistischer Sicht sollte bei Patienten mit schlecht einstellbarem Hypertonus, Vorhofflimmern, koronarer Herzkrankheit und Schlaganfall die Abklärung einer OSA in die Diagnostik integriert werden. Bei Patienten mit milder kognitiver Beeinträchtigung, Alzheimer-Krankheit und Depression können sich die typischen Symptome wie Fatigue, Tagesmüdigkeit und Reduktion der kognitiven Leistungen mit OSA-Symptomen überschneiden. Die Diagnostik einer OSA sollte in die Abklärung dieser Krankheitsbilder integriert werden, da eine Therapie der OSA die kognitiven Beeinträchtigungen reduzieren und die Lebensqualität verbessern kann.

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“…For instance, OSA patients have more lapses and longer reaction times in tasks demanding sustained attention ( Mazza et al, 2005 ; Gelir et al, 2014 ; Karimi et al, 2015 ) while significantly less reaction time after CPAP treatment ( Djonlagic et al, 2015 ). Furthermore, according to the Test of Attentional Performance (TAP), OSA patients manifest deficits in divided and selective attention processes ( Angelelli et al, 2020 ; Alkan et al, 2021 ).…”

Section: Symptoms Of Cognitive Impairment In Osamentioning

confidence: 99%

Summary of drug therapy to treat cognitive impairment-induced obstructive sleep apnea

He,

Chen,

et al. 2023

Front. Cell. Neurosci.

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Obstructive sleep apnea (OSA) is a severe sleep disorder associated with intermittent hypoxia and sleep fragmentation. Cognitive impairment is a signifi- cant and common OSA complication often described in such patients. The most commonly utilized methods in clinical OSA treatment are oral appliances and continuous positive airway pressure (CPAP). However, the current therapeutic methods for improving cognitive function could not achieve the expected efficacy in same patients. Therefore, further understanding the molecular mechanism behind cognitive dysfunction in OSA disease will provide new treatment methods and targets. This review briefly summarized the clinical manifestations of cognitive impairment in OSA disease. Moreover, the pathophysiological molecular mechanism of OSA was outlined. Our study concluded that both SF and IH could induce cognitive impairment by multiple signaling pathways, such as oxidative stress activation, inflammation, and apoptosis. However, there is a lack of effective drug therapy for cognitive impairment in OSA. Finally, the therapeutic potential of some novel compounds and herbal medicine was evaluated on attenuating cognitive impairment based on certain preclinical studies.

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Effects of surgery for obstructive sleep apnea on cognitive function and driving performance

Cited by 7 publications

References 26 publications

Robot-assisted frontofacial correction in very young children with craniofacial dysostosis syndromes: a technical note and early functional outcome

Robot-assisted frontofacial correction in very young children with craniofacial dysostosis syndromes: a technical note and early functional outcome

Obstruktive Schlafapnoe – Einfluss auf kardiovaskuläres System und Kognition

Summary of drug therapy to treat cognitive impairment-induced obstructive sleep apnea

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