Journal of the International Neuropsychological Society

Research Articles

Executive function in patients with obstructive sleep apnea treated with continuous positive airway pressure

ESTHER YUET YING LAUa1 c1, GAIL A. ESKESa2a3a4, DEBRA L. MORRISONa4a5, MALGORZATA RAJDAa2a5 and KATHLEEN F. SPURRa6

a1 Department of Psychology, The University of Hong Kong, Hong Kong, China

a2 Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia

a3 Department of Psychology, Dalhousie University, Halifax, Nova Scotia

a4 Department of Medicine, Dalhousie University, Halifax, Nova Scotia

a5 Sleep Clinic and Laboratory, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia

a6 School of Health Sciences, Dalhousie University, Halifax, Nova Scotia

Abstract

Obstructive sleep apnea (OSA) is characterized by disrupted breathing and hypoxemia during sleep, daytime sleepiness, and changes in cognition and mood. One important question is regarding the reversibility of cognitive deficits after treatment with continuous positive airway pressure (CPAP). Here, we report the outcomes of CPAP treatment as measured by tests of attention and executive function. Thirty-seven individuals with moderate to severe OSA and compliant on CPAP treatment were studied with working memory tasks, neuropsychological testing, and overnight polysomnographic sleep study and compared to 27 healthy controls. CPAP improved the respiratory disturbance index, minimum and mean oxygen saturation (SpO2), subjective sleep quality, and daytime sleepiness ratings compared to pre-treatment values. In terms of current neurocognitive function, treated individuals with OSA performed at a comparable level to controls on basic working memory storage functions but still showed a significant reduction on tests of working memory requiring the central executive. The OSA group also performed worse on neuropsychological measures of complex attention, executive function, and psychomotor speed. While CPAP is an effective treatment for OSA in terms of ameliorating breathing disruption and oxygen desaturation during sleep, as well as daytime sleepiness, some cognitive deficits may be more resistant to treatment. (JINS, 2010, 16, 1077–1088.)

(Received November 04 2009)

(Reviewed July 15 2010)

(Accepted July 15 2010)

Correspondence:

c1 Correspondence and reprint requests to: Esther Yuet Ying Lau, Add: K641, Knowles Building, Department of Psychology, The University of Hong Kong, Pokfulam Road, Hong Kong. E-mail: eyylau@hku.hk

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