The behavioral morbidity of obstructive sleep apnea
Section snippets
Excessive daytime sleepiness
EDS is conceptualized as the heightened propensity to fall asleep while involved in activities that require alertness. It is important to understand that EDS accumulates over time. Initially, affected individuals may only experience sleepiness during the middle of the day, which coincides with one of two peaks in the natural biphasic propensity to fall asleep.1 For patients with OSA, however, EDS may become a chronic experience. The symptoms can not be modulated by extending the amount of
Neurocognitive testing
The mechanism behind neurocognitive deficits in OSA patients is not clearly understood. Many believe that hypoxemia and its biochemical and hemodynamic effects on the central nervous system (CNS) are responsible for impairments found in apneics.[18], [19] Yet others attribute the neurocognitive deficits to EDS.[43], [44], [45] Regardless of causal factors involved, multiple reports in the literature document these deficits in OSA patients. The tests that have been used to assess neurocognitive
Psychosocial impact of OSA
The chronic nature of OSA as well as the actual symptoms accompanying the behavioral morbidity of the disorder, have a significant impact on the patients social, emotional, and psychological well-being. Clinical experience and surveys of this population suggest that problems in the psychosocial life of apneics are the result, not the cause, of the symptoms of OSA.
Kales et al surveyed 50 consecutive severe OSA patients and 80 age and sex-matched controls.63 All patients were required to complete
The reversal of the behavioral morbidity with treatment of OSA
CPAP has become the treatment of choice for moderate and severe OSA patients. CPAP normalizes sleep-disordered breathing and thereby reverses the effects of OSA on sleep fragmentation, hypoxemia, and sleep architecture. Compared with surgical treatment via uvulopalatopharyngoplasty, CPAP renders a more consistent and predictable improvement of sleep disordered breathing.23 However, the effects of CPAP on the reversal of the behavioral morbidity in this population have been controversial. A
Conclusion
The occurrence of repetitive respiratory events during sleep provoke profound changes in the normal physiology of the individual. These changes have both acute and chronic consequences. Sufferers may be exposed to recurrent hypoxemic episodes and pleural pressure swings that create significant ventilatory stress, sleep fragmentation, and the disruption of the homeostatic nature of sleep. From a hemodynamic perspective the changes are also known to be significant, and result in a complex
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Cited by (65)
Determinants of policy decisions for non-commercial drivers with OSA: An integrative review
2018, Sleep Medicine ReviewsCitation Excerpt :Also related to OSA are health risks such as hypertension and obesity, or illnesses such as diabetes and cardiovascular disorders [3–7]. Of particular relevance to driving, excessive daytime sleepiness secondary to OSA has been identified as an important health-related risk in commercial transportation [8–13] with, possibly, an increased chance of road accidents due to impairments in vigilance, concentration, memory, and executive function [14]. The objective of the present review is to summarize the state of knowledge about OSA and risk-related driving behavior among non-commercial drivers.
Sleep disruption increases seizure susceptibility: Behavioral and EEG evaluation of an experimental model of sleep apnea
2016, Physiology and BehaviorCitation Excerpt :Sleep is a vital, natural, periodic and reversible physiological state of decreased vigilance. Therefore, changes in sleep duration and architecture are associated with different diseases, including cardiovascular diseases, neurological disorders, psychosis, bipolar disorder, as well as epilepsy [1]. Sleep deprivation has been identified as one of the leading precipitant factors in patients with epilepsy [2].
" Listening for his breath:" The significance of gender and partner reporting on the diagnosis, management, and treatment of obstructive sleep apnea
2013, Social Science and MedicineCitation Excerpt :There may be decreased cognitive ability, impaired memory, and loss of interest in sex. Over the long-term, apnea is associated with more severe health problems, such as increased risk of traffic or industrial accidents, depression, high blood pressure, stroke, cardiac arrhythmias, and heart failure (Day, Gerhardstein, Lumley, Roth, & Rosenthal, 1999; Findley, Unverzagt, & Suratt, 1988; Yaggi et al., 2005). Population based studies indicate a prevalence range of obstructive sleep apnea syndrome in adults at between 2 and 5% in the general population, though 20% of the adult population may have at least mild sleep apnea symptoms (Young, Peppard, & Gottlieb, 2002).
Age-related tonsillar regrowth in children undergoing powered intracapsular tonsillectomy
2011, International Journal of Pediatric OtorhinolaryngologyCitation Excerpt :Numerous published studies have demonstrated a clear association between SDB and neurocognitive deficits, such as poor memory, difficulty learning, and reduced problem solving ability [1–3]. Behavioral changes such as aggression, hyperactivity, attention-deficit disorder, and poor socialization have also been tied to SDB [4–6]. At its extreme, sleep-disordered breathing can also lead to physical problems stemming primarily from poor ventilation.
Signs and symptoms of obstructive sleep apnea and upper airway resistance syndrome
2009, Sleep Apnea and Snoring