Factors impairing daytime performance in patients with sleep apnea/hypopnea syndrome.

Patients with sleep apnea/hypopnea syndrome commonly demonstrate impaired daytime performance. In a prospective study, 29 patients with sleep apnea/hypopnea syndrome were assessed polysomnographically to determine the relationship of cognitive performance and daytime sleepiness with sleep disruption, hypoxemia, and mood. Deterioration of cognitive performance correlated significantly with increasing severity of nocturnal breathing irregularity, magnitude of nocturnal hypoxemia, and extent of sleep disruption. Multiple regression analysis identified frequency of apneas plus hypopneas and of arousal and the extent of nocturnal hypoxemia as the variables most strongly associated with cognitive deficits. Anxiety and depression also contributed to this impairment. Objective daytime sleepiness was not significantly associated with nocturnal variables. This study showed that the frequency of breathing irregularities and the extent of both sleep disruption and nocturnal hypoxemia are important in determining daytime function in patients with sleep apnea/hypopnea syndrome. All of these factors should be considered when deciding which patients require treatment.

[1]  W C Dement,et al.  Determinants of daytime sleepiness in obstructive sleep apnea. , 1988, Chest.

[2]  N. Nie.  SPSS-X User's Guide , 1983 .

[3]  L J Findley,et al.  Cognitive impairment in patients with obstructive sleep apnea and associated hypoxemia. , 1986, Chest.

[4]  M. Carskadon,et al.  Guidelines for the multiple sleep latency test (MSLT): a standard measure of sleepiness. , 1986, Sleep.

[5]  D. Gronwall.  Paced Auditory Serial-Addition Task: A Measure of Recovery from Concussion , 1977, Perceptual and motor skills.

[6]  J. Blass,et al.  Brain dysfunction in mild to moderate hypoxia. , 1981, The American journal of medicine.

[7]  I. Deary,et al.  Intelligence and ‘Inspection Time’ , 1982 .

[8]  D. Deptula,et al.  Neuropsychological dysfunction in sleep apnea. , 1987, Sleep.

[9]  J. Fleetham,et al.  Treatment Outcome of Obstructive Sleep Apnea: Physiological and Neuropsychological Concomitants , 1987, The Journal of nervous and mental disease.

[10]  N J Douglas,et al.  The sleep hypopnea syndrome. , 1988, The American review of respiratory disease.

[11]  M. Zetin,et al.  Self-reported depressive symptomatology, mood ratings, and treatment outcome in sleep disorders patients. , 1989, Journal of clinical psychology.

[12]  A. Kales,et al.  Severe obstructive sleep apnea--II: Associated psychopathology and psychosocial consequences. , 1985, Journal of chronic diseases.

[13]  Christian Guilleminault,et al.  Clinical overview of the sleep apnea syndromes , 1978 .

[14]  I. Grant,et al.  Neuropsychologic findings in hypoxemic chronic obstructive pulmonary disease. , 1982, Archives of internal medicine.

[15]  N. Douglas,et al.  TRANSIENT HYPOXÆMIA DURING SLEEP IN CHRONIC BRONCHITIS AND EMPHYSEMA , 1979, The Lancet.

[16]  L. Findley,et al.  Driving simulator performance in patients with sleep apnea. , 1989, The American review of respiratory disease.

[17]  O. Parsons,et al.  Neuropsychological test performance in mildly hypoxemic patients with chronic obstructive pulmonary disease. , 1983, Journal of consulting and clinical psychology.

[18]  N J Douglas,et al.  Clinical features of the sleep apnoea/hypopnoea syndrome. , 1989, The Quarterly journal of medicine.

[19]  A. J. Block,et al.  Treatment of Chronic Obstructive Pulmonary Disease at Sea Level , 2017 .

[20]  A. Rechtschaffen,et al.  A manual of standardized terminology, technique and scoring system for sleep stages of human subjects , 1968 .

[21]  T. Roth,et al.  Predictors of objective level of daytime sleepiness in patients with sleep-related breathing disorders. , 1989, Chest.

[22]  M. Kryger,et al.  SLEEP APNOEA PATIENTS HAVE MORE AUTOMOBILE ACCIDENTS , 1987, The Lancet.