School of Psychology Centre for Sleep Science, School of Anatomy, Physiology and Human Biology, The University of Western Australia, Perth, Western Australia, Australia.
Respirology. 2013 Jan;18(1):61-70. doi: 10.1111/j.1440-1843.2012.02255.x.
Adult obstructive sleep apnoea (OSA) is associated with cognitive dysfunction. While many review articles have attempted to summarize the evidence for this association, it remains difficult to determine which domains of cognition are affected by OSA. This is because of marked differences in the nature of these reviews (e.g. many are unsystematic) and the many different tasks and domains assessed. This paper addresses this issue by comparing the results of only systematic reviews or meta-analyses assessing the effects of OSA on cognition, the relationship between OSA severity and cognition, and/or the effects of treatment on cognition in OSA. Electronic databases and hand-searching were undertaken to select reviews that reported on these areas. We found 33 reviews; five reviews met predetermined, stringent selection criteria. The majority of reviews supported deficits in attention/vigilance, delayed long-term visual and verbal memory, visuospatial/constructional abilities, and executive function in individuals with OSA. There is also general agreement that language ability and psychomotor function are unaffected by OSA. Data are equivocal for the effects of OSA on working memory, short-term memory and global cognitive functioning. Attention/vigilance dysfunction appears to be associated with sleep fragmentation and global cognitive function with hypoxaemia. Continuous positive airway pressure treatment of OSA appears to improve executive dysfunction, delayed long-term verbal and visual memory, attention/vigilance and global cognitive functioning. In order to improve our understanding of cognitive dysfunction in OSA, future research should pay particular attention to participant characteristics, measures of disease severity and choice of neuropsychological tests.
成人阻塞性睡眠呼吸暂停（OSA）与认知功能障碍有关。虽然许多综述文章试图总结这种关联的证据，但仍很难确定 OSA 影响哪些认知领域。这是因为这些综述的性质存在明显差异（例如，许多是无系统的），以及评估的任务和领域也很多不同。本文通过比较仅评估 OSA 对认知的影响、OSA 严重程度与认知的关系以及/或 OSA 治疗对认知的影响的系统综述或荟萃分析的结果来解决这个问题。电子数据库和手动搜索用于选择报告这些领域的综述。我们发现了 33 篇综述；其中 5 篇综述符合预定的严格选择标准。大多数综述支持 OSA 患者存在注意力/警觉性、延迟的长期视觉和语言记忆、视空间/结构能力和执行功能缺陷。一般来说，语言能力和精神运动功能不受 OSA 影响也得到了普遍认可。OSA 对工作记忆、短期记忆和整体认知功能的影响的数据存在争议。注意力/警觉性障碍似乎与睡眠碎片化有关，而整体认知功能与低氧血症有关。持续气道正压通气治疗 OSA 似乎可以改善执行功能、延迟的长期语言和视觉记忆、注意力/警觉性和整体认知功能。为了提高我们对 OSA 认知功能障碍的理解，未来的研究应特别关注参与者特征、疾病严重程度的测量和神经心理学测试的选择。
