Changes in neurocognitive architecture in patients with obstructive sleep apnea treated with continuous positive airway pressure.

Rosenzweig, Ivana and Glasser, Martin and Crum, William R. and Kempton, Matthew J. and Milošević, Milan and McMillan, Alison and Leschziner, Guy D. and Kumari, Veena and Goadsby, Peter and Simonds, Anita K. and Williams, Steve C.R. and Morrell, Mary J. (2016) Changes in neurocognitive architecture in patients with obstructive sleep apnea treated with continuous positive airway pressure. EBioMedicine, 7. pp. 221-9. ISSN 2352-3964

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BACKGROUND: Obstructive sleep apnea (OSA) is a chronic, multisystem disorder that has a bidirectional relationship with several major neurological disorders, including Alzheimer's dementia. Treatment with Continuous Positive Airway Pressure (CPAP) offers some protection from the effects of OSA, although it is still unclear which populations should be targeted, for how long, and what the effects of treatment are on different organ systems. We investigated whether cognitive improvements can be achieved as early as one month into CPAP treatment in patients with OSA. ----- METHODS: 55 patients (mean (SD) age: 47.6 (11.1) years) with newly diagnosed moderate-severe OSA (Oxygen Desaturation Index: 36.6 (25.2) events/hour; Epworth sleepiness score (ESS): 12.8 (4.9)) and 35 matched healthy volunteers were studied. All participants underwent neurocognitive testing, neuroimaging and polysomnography. Patients were randomized into parallel groups: CPAP with best supportive care (BSC), or BSC alone for one month, after which they were re-tested. ----- FINDINGS: One month of CPAP with BSC resulted in a hypertrophic trend in the right thalamus [mean difference (%): 4.04, 95% CI: 1.47 to 6.61], which was absent in the BSC group [-2.29, 95% CI: -4.34 to -0.24]. Significant improvement was also recorded in ESS, in the CPAP plus BSC group, following treatment [mean difference (%): -27.97, 95% CI: -36.75 to -19.19 vs 2.46, 95% CI: -5.23 to 10.15; P=0.012], correlated to neuroplastic changes in brainstem (r=-0.37; P=0.05), and improvements in delayed logical memory scores [57.20, 95% CI: 42.94 to 71.46 vs 23.41, 95% CI: 17.17 to 29.65; P=0.037]. ----- INTERPRETATION: One month of CPAP treatment can lead to adaptive alterations in the neurocognitive architecture that underlies the reduced sleepiness, and improved verbal episodic memory in patients with OSA. We propose that partial neural recovery occurs during short periods of treatment with CPAP.

Item Type: Article
Additional Information: © 2016 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (
MeSH: Adult ; Brain/diagnostic imaging ; Cognition/physiology ; Continuous Positive Airway Pressure/methods ; Female ; Humans Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Neuropsychological Tests ; Polysomnography ; Quality of Life ; Random Allocation ; Sleep Apnea, Obstructive/pathology ; Sleep Apnea, Obstructive/therapy ; Treatment Outcome
Departments: Katedra za zdravstvenu ekologiju i medicinu rada
Depositing User: Martina Žužak
Status: Published
Rosenzweig, IvanaUNSPECIFIED
Glasser, MartinUNSPECIFIED
Kempton, Matthew J.UNSPECIFIED
Milošević, MilanUNSPECIFIED
Leschziner, Guy D.UNSPECIFIED
Simonds, Anita K.UNSPECIFIED
Williams, Steve C.R.UNSPECIFIED
Date: 7 May 2016
Date Deposited: 11 Oct 2017 07:49
Last Modified: 11 Oct 2017 07:49
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