Vaioli Giulia, Tagini Sofia, Scarpina Federica, Cremascoli Riccardo, Priano Lorenzo, Cornacchia Mauro, Fanari Paolo, Mauro Alessandro
I.R.C.C.S. Istituto Auxologico Italiano, U.O. di Neurologia e Neuroriabilitazione, Ospedale San Giuseppe, 28824 Piancavallo, VCO, Italy.
"Rita Levi Montalcini" Department of Neurosciences, University of Turin, 10124 Turin, Italy.
Brain Sci. 2023 Jan 10;13(1):124. doi: 10.3390/brainsci13010124.
The Obstructive Sleep Apnea Syndrome (OSAS) significantly impacts cognitive functioning. The prolonged use (more than 3 months) of ventilotherapy with continuous positive airway pressure (CPAP) seems to have positive effects in restoring cognitive difficulties. However, there is poor evidence about its possible short-term effect. We investigated whether the short use (less than 15 days at testing) of CPAP improved the cognitive functioning in fifty individuals with OSAS by collecting retrospective neuropsychological measures about verbal memory and learning, information processing speed, attention (i.e., alerting, orienting, and executive system), and executive functions (i.e., strategic reasoning, problem-solving, and mental planning). The predictive role of days of CPAP use on the neuropsychological scores was assessed by hierarchical multiple linear regression analyses, over and above the possible role of demographics, body mass index, level of OSAS severity, and the level of anxiety and depression. The average number of days since CPAP adaptation was 4.70 (SD = 3.90; range = 0-15). As the days of CPAP adaptation increased, verbal learning and long-term memory significantly improved, contrary to the other assessed domains. Our results show a significant improvement in some cognitive functions even after a short treatment with CPAP, pointing to the importance of the early use of ventilotherapy to rapidly improve cognitive functioning. Identifying which cognitive functions can or cannot be restored with CPAP use may enable the design of complementary neuropsychological interventions focused on those residual difficulties, possibly enhancing patients' compliance to the treatment.
阻塞性睡眠呼吸暂停综合征(OSAS)对认知功能有显著影响。持续气道正压通气(CPAP)进行通气治疗的长期使用(超过3个月)似乎对恢复认知障碍有积极作用。然而,关于其可能的短期效果的证据不足。我们通过收集关于言语记忆与学习、信息处理速度、注意力(即警觉、定向和执行系统)以及执行功能(即策略推理、问题解决和心理规划)的回顾性神经心理学测量数据,研究了CPAP的短期使用(测试时使用少于15天)是否能改善50名OSAS患者的认知功能。通过分层多元线性回归分析评估CPAP使用天数对神经心理学分数的预测作用,同时考虑人口统计学、体重指数、OSAS严重程度水平以及焦虑和抑郁水平的可能作用。CPAP适应后的平均天数为4.70(标准差 = 3.90;范围 = 0 - 15)。随着CPAP适应天数的增加,言语学习和长期记忆显著改善,与其他评估领域情况相反。我们的结果表明,即使在CPAP短期治疗后,某些认知功能也有显著改善,这表明早期使用通气治疗以快速改善认知功能的重要性。确定哪些认知功能可以或不可以通过使用CPAP恢复,可能有助于设计针对那些残留困难的补充性神经心理学干预措施,从而可能提高患者对治疗的依从性。