Vanek Jakub, Prasko Jan, Genzor Samuel, Ociskova Marie, Kantor Krystof, Holubova Michaela, Slepecky Milos, Nesnidal Vlastimil, Kolek Antonin, Sova Milan
Department of Psychiatry, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, the Czech Republic.
Department of Psychiatry, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, the Czech Republic; Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, the Slovak Republic.
Sleep Med. 2020 Aug;72:50-58. doi: 10.1016/j.sleep.2020.03.017. Epub 2020 Mar 23.
Obstructive sleep apnea (OSA) is a severe disorder with a high prevalence. Psychiatric comorbidities, especially depressive symptoms and cognitive dysfunction, are often described in OSA patients. This narrative review aims to examine: (1) the relationship between obstructive sleep apnea syndrome (OSAS) and depressive and cognitive symptoms, and (2) the effect of OSAS treatment on psychiatric symptoms.
Articles that were published between January 1990 and August 2018 were searched and extracted via PubMed, and Web of Science databases. Authors analyzed the papers and its references using the following keywords: obstructive sleep apnea, depression, cognitive dysfunction, anxiety disorders, and continuous positive airway pressure (CPAP). A total of 632 articles were nominated. After the selection according to the inclusion and exclusion criteria, 172 articles were chosen. After complete inspection of the full texts, finally, 58 papers were selected. Secondary papers from the reference lists of the primarily designated papers were also searched, assessed for suitability, and added to the first list of the papers (n = 67). In total, 125 papers were included in this review.
There is a significant overlap in depressive, anxious and OSA symptoms. Studies also show that attention, working memory, episodic memory, and executive functions are decreased in OSA. Conversely, most of verbal functions remain intact and variable results are found in psychomotor speed. Several studies implicated that in some fields of cognitive functions (eg, attention) deficit caused by untreated OSA can be irreversible and shows only partial recovery after a period of treatment with CPAP.
Untreated OSA impacts affective disorders, and often leads to decline of cognitive functions or even leads to permanent brain damage. Further studies are needed to analyze the connection between OSA and affective disorders, anxiety disorders and its effect on cognitive functions more thoroughly, especially in the context of CPAP treatment.
阻塞性睡眠呼吸暂停（OSA）是一种患病率很高的严重疾病。OSA患者常伴有精神疾病共病，尤其是抑郁症状和认知功能障碍。本叙述性综述旨在探讨：（1）阻塞性睡眠呼吸暂停综合征（OSAS）与抑郁及认知症状之间的关系，以及（2）OSAS治疗对精神症状的影响。
通过PubMed和科学网数据库检索并提取1990年1月至2018年8月发表的文章。作者使用以下关键词分析论文及其参考文献：阻塞性睡眠呼吸暂停、抑郁、认知功能障碍、焦虑症和持续气道正压通气（CPAP）。共筛选出632篇文章。根据纳入和排除标准进行筛选后，选择了172篇文章。在对全文进行全面审查后，最终选择了58篇论文。还检索了主要指定论文参考文献列表中的次要论文，评估其适用性，并添加到论文的第一列表中（n = 67）。本综述共纳入125篇论文。
抑郁、焦虑和OSA症状之间存在显著重叠。研究还表明，OSA患者的注意力、工作记忆、情景记忆和执行功能下降。相反，大多数语言功能保持完整，心理运动速度的结果不一。几项研究表明，在认知功能的某些领域（如注意力），未经治疗的OSA导致的缺陷可能是不可逆的，并且在接受CPAP治疗一段时间后仅显示部分恢复。
未经治疗的OSA会影响情感障碍，常导致认知功能下降，甚至导致永久性脑损伤。需要进一步研究更全面地分析OSA与情感障碍、焦虑症之间的联系及其对认知功能的影响，尤其是在CPAP治疗的背景下。
