The Association between Obstructive Sleep Apnea and Neurocognitive Performance-The Apnea Positive Pressure Long-term Efficacy Study (APPLES)

The Association between Obstructive Sleep Apnea and Neurocognitive Performance-The Apnea Positive Pressure Long-term Efficacy Study (APPLES)
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DOI：
10.1093/sleep/34.3.303
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发表时间：
2011-03-01
期刊：
SLEEP
影响因子：
5.6
通讯作者：
Kushida, Clete A.
Kushida, Clete A.
中科院分区：
医学2区
文献类型：
--
作者：
Quan, Stuart F.;Chan, Cynthia S.;Kushida, Clete A.

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研究目的：在一个大型成人队列中确定阻塞性睡眠呼吸暂停（OSA）与神经认知表现之间的关系。研究设计：在呼吸暂停正压长期疗效研究（apple）中，对1204名临床诊断为阻塞性睡眠呼吸暂停（OSA）的成年参与者的多导睡眠图和神经认知数据进行横断面分析，在随机分配到持续气道正压（CPAP）或假CPAP之前进行基线评估。测量：睡眠和呼吸指数通过实验室多导睡眠图和神经认知表现的几种测量获得。结果：在未经调整的分析中，呼吸暂停低通气指数（AHI）与氧去饱和度和神经认知表现的几个指标均存在弱相关性。在对教育水平、种族和性别进行调整后，AHI与神经认知表现之间没有关联。然而，在智力、注意力和处理速度的一些测量中，氧饱和度的严重程度与较差的神经认知表现弱相关。结论：OSA对许多患者的神经认知能力的影响很小，主要与低氧血症的严重程度有关。
Study Objectives: To determine associations between obstructive sleep apnea (OSA) and neurocognitive performance in a large cohort of adults.Study Design: Cross-sectional analyses of polysomnographic and neurocognitive data from 1204 adult participants with a clinical diagnosis of obstructive sleep apnea (OSA) in the Apnea Positive Pressure Long-term Efficacy Study (APPLES), assessed at baseline before randomization to either continuous positive airway pressure (CPAP) or sham CPAP.Measurements: Sleep and respiratory indices obtained by laboratory polysomnography and several measures of neurocognitive performance.Results: Weak correlations were found for both the apnea hypopnea index (AHI) and several indices of oxygen desaturation and neurocognitive performance in unadjusted analyses. After adjustment for level of education, ethnicity, and gender, there was no association between the AHI and neurocognitive performance. However, severity of oxygen desaturation was weakly associated with worse neurocognitive performance on some measures of intelligence, attention, and processing speed.Conclusions: The impact of OSA on neurocognitive performance is small for many individuals with this condition and is most related to the severity of hypoxemia.