Djonlagic Ina, Guo Mengshuang, Matteis Paul, Carusona Andrea, Stickgold Robert, Malhotra Atul
Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Center for Sleep and Cognition, Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Division of Sleep Medicine, Sleep Disorders Program Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA.
Center for Sleep and Cognition, Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Division of Sleep Medicine, Sleep Disorders Program Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA.
Sleep Med. 2015 Jun;16(6):697-702. doi: 10.1016/j.sleep.2015.01.017. Epub 2015 Feb 27.
Neurocognitive deficits are common and serious consequences of obstructive sleep apnea (OSA). Currently, the gold standard treatment is continuous positive air pressure (CPAP) therapy, although the clinical responses to this intervention can be variable. This study examined the effect of one night of CPAP therapy on sleep-dependent memory consolidation, attention, and vigilance as well as subjective experience.
Fifteen healthy controls and 29 patients with obstructive sleep apnea of whom 14 underwent a full-night CPAP titration completed the psychomotor vigilance test (PVT) and motor sequence learning task (MST) in the evening and the morning after undergoing overnight polysomnography. All participants also completed subjective evaluations of sleep quality.
Participants with OSA showed significantly less overnight improvement on the MST compared to controls without OSA, independent of whether or not they had received CPAP treatment, while there was no significant difference between the untreated OSA and CPAP-treated patients. Within the OSA group, only those receiving CPAP exhibited faster reaction times on the PVT in the morning. Compared to untreated OSA patients, they also felt subjectively more rested and reported that they slept better.
Our results demonstrate an instant augmentation of subjective experience and, based on PVT results, attention and vigilance after one night of CPAP, but a lack of an effect on offline sleep-dependent motor memory consolidation. This dissociation may be explained by different brain structures underlying these processes, some of which might require longer continued adherence to CPAP to generate an effect.
神经认知缺陷是阻塞性睡眠呼吸暂停（OSA）常见且严重的后果。目前，金标准治疗方法是持续气道正压通气（CPAP）治疗，尽管这种干预措施的临床反应可能存在差异。本研究探讨了一晚CPAP治疗对睡眠依赖性记忆巩固、注意力和警觉性以及主观体验的影响。
15名健康对照者和29名阻塞性睡眠呼吸暂停患者（其中14人进行了整夜CPAP滴定）在接受整夜多导睡眠图检查后的晚上和早晨完成了精神运动警觉性测试（PVT）和运动序列学习任务（MST）。所有参与者还完成了睡眠质量的主观评估。
与无OSA的对照组相比，OSA患者在MST上的夜间改善明显较少，无论他们是否接受CPAP治疗，而未治疗的OSA患者和接受CPAP治疗的患者之间没有显著差异。在OSA组中，只有接受CPAP治疗的患者在早晨的PVT上反应时间更快。与未治疗的OSA患者相比，他们主观上感觉更休息好了，并且报告说他们睡得更好。
我们的结果表明，一晚CPAP治疗后主观体验即刻增强，基于PVT结果，注意力和警觉性也增强，但对离线睡眠依赖性运动记忆巩固没有影响。这种分离可能是由这些过程背后的不同脑结构所解释的，其中一些可能需要更长时间持续坚持CPAP治疗才能产生效果。
