Felver-Gant Joshua C, Bruce Amanda S, Zimmerman Molly, Sweet Lawrence H, Millman Richard P, Aloia Mark S
Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA.
J Clin Sleep Med. 2007 Oct 15;3(6):589-94.
To better understand the effects of obstructive sleep apnea (OSA) on working memory performance. We first examined the construct validity of a working memory task (the 2-Back task) and its relationship to other tests of cognitive functioning, and then determined the effects of positive airway pressure (PAP) treatment on measures of both working memory and its related component processes.
Fifty-six participants with OSA were administered cognitive tests of working memory and related subordinate cognitive processes prior to initiation of PAP treatment and at a 3-month follow-up visit. Objective monitors were employed to measure PAP treatment adherence. Statistical analyses were conducted to examine treatment adherence and cognitive performance over time.
Performance on the 2-Back task was statistically correlated with both a second working memory task (PASAT) and all subordinate cognitive measures. Participants were separated into high and low PAP adherence groups using a median split of 4 hours of PAP use per night. Repeated measures ANOVAs demonstrated that high adherers performed better across time on both tests of working memory (2-Back: F46 = 4.73, p <0.04; PASAT: F46 = 4.92, p <0.04) whereas low adherers performed more poorly. There were no treatment effects for any other cognitive measure.
The 2-Back task demonstrated adequate construct validity as a measurement of working memory in individuals with OSA. Our treatment adherence findings suggest that the construct of working memory is more sensitive to the effects OSA treatment than are any of its subordinate cognitive processes.
为了更好地理解阻塞性睡眠呼吸暂停（OSA）对工作记忆表现的影响。我们首先检验了一项工作记忆任务（2-回溯任务）的结构效度及其与其他认知功能测试的关系，然后确定了气道正压通气（PAP）治疗对工作记忆及其相关组成过程测量指标的影响。
56名阻塞性睡眠呼吸暂停患者在开始PAP治疗前以及3个月随访时接受了工作记忆及相关从属认知过程的认知测试。采用客观监测器测量PAP治疗依从性。进行统计分析以检验治疗依从性和随时间变化的认知表现。
2-回溯任务的表现与第二项工作记忆任务（PASAT）以及所有从属认知测量指标均存在统计学相关性。根据每晚使用PAP 4小时的中位数划分，将参与者分为高PAP依从组和低PAP依从组。重复测量方差分析表明，高依从者在两项工作记忆测试中随时间推移表现更好（2-回溯任务：F46 = 4.73，p <0.04；PASAT：F46 = 4.92，p <0.04），而低依从者表现更差。其他任何认知测量指标均未发现治疗效果。
2-回溯任务作为阻塞性睡眠呼吸暂停个体工作记忆的一种测量方法，显示出足够的结构效度。我们关于治疗依从性的研究结果表明，工作记忆结构比其任何从属认知过程对阻塞性睡眠呼吸暂停治疗的影响更敏感。
