PERSISTENT NEUROPSYCHOLOGICAL DEFICITS AND VIGILANCE IMPAIRMENT IN SLEEP-APNEA SYNDROME AFTER TREATMENT WITH CONTINUOUS POSITIVE AIRWAYS PRESSURE (CPAP)

The obstructive sleep apnea syndrome is characterized by nocturnal sle ep disturbance, excessive daytime sleepiness and neuropsychological de ficits in the areas of memory, attention, and executive tasks. In the present study, these clinical manifestations were assessed in apneic p atients before and 6 months after treatment with nasally applied conti nuous positive airway pressure (CPAP). CPAP treatment was found to res tore normal respiration during sleep and to normalize sleep organizati on. Daytime vigilance greatly improved with treatment but some degree of somnolence as compared to normal controls persisted. Similarly, mos t neuropsychological deficits normalized with treatment. The exception was for planning abilities and manual dexterity, two neuropsychologic al deficits that have been found to be highly correlated with the seve rity of nocturnal hypoxemia. These results raise the possibility that anoxic brain damage is a pathogenic factor in severe obstructive sleep apnea syndrome.