Bruin Pedro Felipe Carvalhedo de, Bagnato Mauricio da Cunha
Departamento de Medicina Clínica, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil.
J Bras Pneumol. 2010 Jun;36 Suppl 2:32-7. doi: 10.1590/s1806-37132010001400010.
Cognitive and performance impairment is well established in patients with obstructive sleep apnea syndrome (OSAS), having a significant impact on the quality of life and the risk of accidents in these individuals. The severity of the impairment correlates with that of the OSAS, which explains the apparent discrepancy between studies using patients from sleep clinics and population-based studies in terms of the reported frequency and severity of such impairment. Cognitive processing, sustained attention, executive functioning, and memory have all been reported to be impaired in OSAS. However, the causal mechanisms of these deficits have not been entirely clarified, and the relative contribution of intermittent hypoxia and sleep disruption in OSAS is particularly controversial. The potential effect of daytime sleepiness on the performance of these patients on various cognitive tests has yet to be determined, as does that of common comorbidities, such as diabetes, systemic arterial hypertension, cardiovascular disease, and obesity. There is compelling evidence that CPAP treatment can improve performance and cognition, particularly in mild to moderate cases, although further studies on the long-term impact of this type of treatment are still needed.
阻塞性睡眠呼吸暂停综合征（OSAS）患者存在认知和行为能力损害，这对这些个体的生活质量和事故风险有重大影响。损害的严重程度与OSAS的严重程度相关，这解释了在使用睡眠诊所患者的研究与基于人群的研究之间，在所报告的此类损害的频率和严重程度方面存在明显差异的原因。据报道，OSAS患者的认知加工、持续注意力、执行功能和记忆均受到损害。然而，这些缺陷的因果机制尚未完全阐明，OSAS中间歇性缺氧和睡眠中断的相对作用尤其具有争议性。白天嗜睡对这些患者在各种认知测试中的表现的潜在影响尚未确定，糖尿病、系统性动脉高血压、心血管疾病和肥胖等常见合并症的影响也未确定。有令人信服的证据表明，持续气道正压通气（CPAP）治疗可以改善表现和认知，特别是在轻度至中度病例中，尽管仍需要对这种治疗的长期影响进行进一步研究。
