Cognitive and Emotional Impairments in Obstructive Sleep Apnea Syndrome

摘要

Objective: To evaluate the P3 latency in OSAS patients ,snorers and nonsnore subjects and observe the emotional disturbance in OSAS patients. Backround: Neurobehavioral abnormalities are the most common nonrespiratory manifestations in OSAS. Impairment of cognitive functions, as well as emotional disturbances and abnormal P3 latency in OSAS have been documnerted. However, seldom studies were done on comparing the changes the P3 and memory function between OSAS patients and snorers, and the psychological scales of OSAS patients before and after CPAP treatrment Methods: For P3 and memory study, three groups: OSAS group, snorer group, and nosnorer group,21 sub jects each, were administered PSG, ERP and Clinical Memory Test All data were analyzed by General Linear Model; For psychological scales, 16 OSAS patients were tested by SAS,SDS,HRSD and HRSA. Two-tailed students t-test was used for data analysis. A value of p＜0.05 was considered statistically significant. Results: The P3 latency in OSAS patients were significant longer than that in snorers and nosnorers. There′s no signficant difference between snorers and norsnorers. No differerces in amplitude were seen among three groups. Scores of MQ and sulbtest FRP was higher than that ofOSAS group and nonsnorers group. Differences in MSO2 and SE among three groups were noticed. Twelve patients′ scores of SDS, SAS, HAMD and HAMA were beyond the normal range. The scores decreased significantly after three months treatment of CPAP. Discussion: Our study revealed the prolonged P3 latency with auditory evoked potential which indicated the impairment of cognitive function in OSAS patients. Deficits of memory were also documented in OSAS patients. As to our knowledge, snoreres were not exclude from controls subjects in many studies when compared with OSAS patient. In our study, data showed significant difference between srorers and nonsnore subjects in merb SO2 value although no difference was seen in the P3 latency. The mechanism of cognitive impairment in OSAS was not clear. The results of our study showed that there was significant negative correlation between the P3 latency and mean SO2 value. All of these data indicated that hypoxemia might be related to cognitive dysfunction. Emotional disturbances were common clinical features in OSAS. Major depression and psychosis were presented in a higher percentage. In our study, 75% patients had higher neuropsychological scores that were beyond the normal range. Among them, depression was more evident With regard to the therapy of CPAP ,we confirmed its effectiveness. The neuropsychological sores were significantly decreased after treatment Conclusion: The principal conclusion of the present study were that the P3 latency were prolonged in OSAS patients and snorers might had a tendency developing cognitive dysfunction It was also demonstrated that emotional disturbances in OSAS might be reversed ,and CPAP therapy might play on important role in treating these disturbances.