Associations Between Sleep Quality, Sleep Architecture and Sleep Disordered Breathing and Memory After Continuous Positive Airway Pressure in Patients with Obstructive Sleep Apnea in the Apnea Positive Pressure Long-term Efficacy Study (APPLES)
Objective: The role of sleep architecture in consolidation of memory has not been extensively investigated. In this study, the association of continuous positive airway pressure (CPAP) and sleep architecture and quality, and sleep disordered breathing on changes in memory are explo...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Thieme Revinter Publicações Ltda.
2018-12-01
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| Series: | Sleep Science |
| Subjects: | |
| Online Access: | http://sleepscience.org.br/export-pdf/520/ssci-11-04-0231.pdf |
| Summary: | Objective: The role of sleep architecture in consolidation of memory has not been extensively
investigated. In this study, the association of continuous positive airway pressure (CPAP) and sleep
architecture and quality, and sleep disordered breathing on changes in memory are explored during
the course of a 6 month clinical trial of CPAP or sham CPAP (APPLES). Methods: 848 participants
had polysomnographic and memory assessments (Buschke Selective Reminding Test [Buschke] and
Digit Symbol Substitution Test [DSST]) at baseline, CPAP/Sham CPAP titration, and the 2 and 6
month time points. Half were assigned to the CPAP and Sham CPAP groups respectively. Changes
in performance on the Buschke and the DSST were analyzed over the course of the study between
CPAP and Sham CPAP as well as in relationship to changes in sleep architecture, sleep quality and
sleep disordered breathing (SDB). Results: Sleep architecture, sleep quality and SDB improved in
the CPAP group at 6 months; performance on the Buschke and DSST improved equally in both
CPAP and Sham CPAP groups. There also were no significant correlations between changes in
the amount or percentage of sleep stages between baseline and the 6 months, and corresponding
changes in either the Buschke or the DSST. However, when stratified by the upper quartile and
lower 3 quartiles, greater changes in the Buschke occurred over 6 months in the top quartile of
total sleep time (5.7±7.3 vs. 4.0±6.8, p≤0.01) and amount of N3 sleep (55.9±7.7 vs. 53.6±8.9
min, p≤0.01). Those with more %N3 at 6 months scored better on the Buschke as well (55.9±7.8
vs. 53.6±8.9, p≤0.01). Borderline improvement in the DSST over 6 months was observed in the
top quartiles of amount of N3 and %N3. Those in the top quartile of the amount of REM and
%REM also showed greater improvement in the Buschke after 6 months. No differences were
observed for the AHI, but those in the top quartile of oxygen desaturation had worse scores on
the Buschke at 6 months. CPAP/Sham CPAP adherence did not impact 6 month Buschke or DSST
performance. Conclusions: CPAP improved long-term sleep duration, quality and architecture,
but did not memory. However, large changes in REM and N3 sleep as well as moderate amounts of
nocturnal hypoxemia are associated with changes in assessments of memory. |
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| ISSN: | 1984-0659 1984-0063 |