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Cognitive Evaluation in Patients With Obstructive Sleep Apnea Syndrome
Cognitive disorders were described in patients with poor sleep quality.Obstructive sleep apnea syndrome (OSA) is a natural condition that allows and favors the study of cognition in people affected by the disease, since it is possible to separate individuals with different degrees of sleep fragmentation, changes in their macrostructure, efficiency, arterial saturation, and different levels of education.
To evaluate possible differences in cognitive impairment (measured by validated instruments) in people with different degrees of OSA (evaluated by full-night polyssomnography).
A cross-sectional study with 200 patients over 18 years of age sent for polysomnographic examination conducted between 2015-2017.The outcomes were based on the cognitive performance tests: Scales of similarities, verbal fluency, Go-No-Go, metaphorical proverbs. The interest exposure was the diagnosis of OSA and, as potential confounders: schooling, arterial hypertension, smoking, age, weight, psychiatric disorders evaluated by the Montgomery and Hamilton scales.The analysis of the association between the presence of OSA and cognitive performance was analyzed by the non-parametric Mann-Whitney and Chi-square tests.
Subjects with OSA have a fragmented sleep, with% values of time in N1 and N2 higher, with% of time in N3 lower, with more nocturnal awakenings and with a longer sleep time with oxygen saturation below 92%.In the absence of confounders, the comparison between subjects with/without sleep apnea didn't reveal significant differences between these two groups in relation to cognitive performance on the similarity scale, Go-No-Go scale,more metaphorical proverbs scores, less metaphorical proverbs and the general score.Analyzes made with SPSS V21.0 software. When associating degrees of apnea with cognitive performance, no significant differences were observed between the absent, mild, moderate and severe groups. In addition, stratification was made between subjects according to schooling and no significant difference was found.
Cognitive and emotional assessment data showed that there was no significant difference.The findings refer to people with basic and secondary education and can't be generalized to different levels of education.Therefore, one may suspect that in the studied group, sleep fragmentation did not worsen intellectual performance, or that the chosen instruments were not sensitive enough to distinguish people with cognitive disorders.
Obstructive sleep apnea, cognition
Mayra Magalhães Silva, Hélio Rubens de Carvalho Nunes, Ronaldo Guimarães Fonseca