The Neuropsychological Profile of Attention Deficits of Patients with Obstructive Sleep Apnea: An Update on the Daytime Attentional Impairment
Introduction: Patients with obstructive sleep apnea (OSA) suffer from several neurocognitive disturbances. One of the neuropsychological processes most investigated in OSA patients is attention, but the results have been controversial. Here, we update the attention profile of OSA patients with the f...
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| Format: | Article |
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MDPI AG
2020-05-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/10/6/325 |
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| author | Paola Angelelli Luigi Macchitella Domenico Maurizio Toraldo Elena Abbate Chiara Valeria Marinelli Michele Arigliani Michele De Benedetto |
| author_facet | Paola Angelelli Luigi Macchitella Domenico Maurizio Toraldo Elena Abbate Chiara Valeria Marinelli Michele Arigliani Michele De Benedetto |
| author_sort | Paola Angelelli |
| collection | DOAJ |
| description | Introduction: Patients with obstructive sleep apnea (OSA) suffer from several neurocognitive disturbances. One of the neuropsychological processes most investigated in OSA patients is attention, but the results have been controversial. Here, we update the attention profile of OSA patients with the final aim to improve attention assessment, with a possible impact on clinical and medical-legal practices, in terms of which attention subdomains and parameters need consideration and which one is a high-risk OSA phenotype for attention dysfunctions. Method: For this purpose, we assessed 32 previously untreated OSA patients (26 men and 6 women) under 65 years of age (mean age 53.2 ± 7.3; mean education level 10.4 ± 3.4 years) suffering from moderate to severe sleep apnea and hypopnea (mean apnea-hypopnea index (AHI) 45.3 ± 22.9, range 16.1–69.6). A control group of 34 healthy participants matched with OSA patients for age, education level, and general cognitive functioning were also enrolled. The OSA patients and healthy participants were tested through an extensive computerized battery (Test of Attentional Performance, TAP) that evaluated intensive (i.e., alertness and vigilance) and selective (i.e., divided and selective) dimensions of attention and returned different outcome parameters (i.e., reaction time, stability of performance, and various types of errors). Data analysis: The data were analyzed by ANCOVA which compared the speed and accuracy performance of the OSA and control participants (cognitive reserve was treated as a covariate). The possible mechanisms underlying attention deficits in OSA patients were examined through correlation analysis among AHI, oxygenation parameters, sleepiness scores, and TAP outcomes and by comparing the following three phenotypes of patients: severe OSA and severe nocturnal desaturators (AHI<sup>++</sup>D<sup>+</sup>), severe OSA nondesaturators (AHI<sup>++</sup>D<sup>−</sup>), and moderate OSA nondesaturators (AHI<sup>+</sup>D<sup>−</sup>). Results: The results suggest that the OSA patients manifest deficits in both intensive and selective attention processes and that reaction time (RT) alone is ineffective for detecting and characterizing their problems, for which error analysis and stability of performance also have to be considered. Patients with severe OSA and severe hypoxemia underperformed on alertness and vigilance attention subtests. Conclusions: The data suggest the importance of evaluating attention deficits among OSA patients through several parameters (including performance instability). Moreover, the data suggest a multifaceted mechanism underlying attention dysfunction in OSA patients. |
| first_indexed | 2024-03-10T19:34:11Z |
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| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-03-10T19:34:11Z |
| publishDate | 2020-05-01 |
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| spelling | doaj.art-e4a89a5169a0417c9843946b8bc1347b2023-11-20T01:53:46ZengMDPI AGBrain Sciences2076-34252020-05-0110632510.3390/brainsci10060325The Neuropsychological Profile of Attention Deficits of Patients with Obstructive Sleep Apnea: An Update on the Daytime Attentional ImpairmentPaola Angelelli0Luigi Macchitella1Domenico Maurizio Toraldo2Elena Abbate3Chiara Valeria Marinelli4Michele Arigliani5Michele De Benedetto6Lab of Applied Psychology and Intervention, Department of History, Society and Human Studies, University of Salento, 73100 Lecce, ItalyLab of Applied Psychology and Intervention, Department of History, Society and Human Studies, University of Salento, 73100 Lecce, Italy“V. Fazzi” Hospital Rehabilitation Department, Respiratory Care Unit, ASL, 73100 Lecce, ItalyLab of Applied Psychology and Intervention, Department of History, Society and Human Studies, University of Salento, 73100 Lecce, ItalyLab of Applied Psychology and Intervention, Department of History, Society and Human Studies, University of Salento, 73100 Lecce, Italy“V. Fazzi” Hospital, ENT, ASL, 73100 Lecce, Italy“V. Fazzi” Hospital, ENT, ASL, 73100 Lecce, ItalyIntroduction: Patients with obstructive sleep apnea (OSA) suffer from several neurocognitive disturbances. One of the neuropsychological processes most investigated in OSA patients is attention, but the results have been controversial. Here, we update the attention profile of OSA patients with the final aim to improve attention assessment, with a possible impact on clinical and medical-legal practices, in terms of which attention subdomains and parameters need consideration and which one is a high-risk OSA phenotype for attention dysfunctions. Method: For this purpose, we assessed 32 previously untreated OSA patients (26 men and 6 women) under 65 years of age (mean age 53.2 ± 7.3; mean education level 10.4 ± 3.4 years) suffering from moderate to severe sleep apnea and hypopnea (mean apnea-hypopnea index (AHI) 45.3 ± 22.9, range 16.1–69.6). A control group of 34 healthy participants matched with OSA patients for age, education level, and general cognitive functioning were also enrolled. The OSA patients and healthy participants were tested through an extensive computerized battery (Test of Attentional Performance, TAP) that evaluated intensive (i.e., alertness and vigilance) and selective (i.e., divided and selective) dimensions of attention and returned different outcome parameters (i.e., reaction time, stability of performance, and various types of errors). Data analysis: The data were analyzed by ANCOVA which compared the speed and accuracy performance of the OSA and control participants (cognitive reserve was treated as a covariate). The possible mechanisms underlying attention deficits in OSA patients were examined through correlation analysis among AHI, oxygenation parameters, sleepiness scores, and TAP outcomes and by comparing the following three phenotypes of patients: severe OSA and severe nocturnal desaturators (AHI<sup>++</sup>D<sup>+</sup>), severe OSA nondesaturators (AHI<sup>++</sup>D<sup>−</sup>), and moderate OSA nondesaturators (AHI<sup>+</sup>D<sup>−</sup>). Results: The results suggest that the OSA patients manifest deficits in both intensive and selective attention processes and that reaction time (RT) alone is ineffective for detecting and characterizing their problems, for which error analysis and stability of performance also have to be considered. Patients with severe OSA and severe hypoxemia underperformed on alertness and vigilance attention subtests. Conclusions: The data suggest the importance of evaluating attention deficits among OSA patients through several parameters (including performance instability). Moreover, the data suggest a multifaceted mechanism underlying attention dysfunction in OSA patients.https://www.mdpi.com/2076-3425/10/6/325obstructive sleep apnea (OSA)chronic intermittent hypoxia (CIH)excessive daytime sleepiness (EDS)alertnessvigilanceselective attention |
| spellingShingle | Paola Angelelli Luigi Macchitella Domenico Maurizio Toraldo Elena Abbate Chiara Valeria Marinelli Michele Arigliani Michele De Benedetto The Neuropsychological Profile of Attention Deficits of Patients with Obstructive Sleep Apnea: An Update on the Daytime Attentional Impairment Brain Sciences obstructive sleep apnea (OSA) chronic intermittent hypoxia (CIH) excessive daytime sleepiness (EDS) alertness vigilance selective attention |
| title | The Neuropsychological Profile of Attention Deficits of Patients with Obstructive Sleep Apnea: An Update on the Daytime Attentional Impairment |
| title_full | The Neuropsychological Profile of Attention Deficits of Patients with Obstructive Sleep Apnea: An Update on the Daytime Attentional Impairment |
| title_fullStr | The Neuropsychological Profile of Attention Deficits of Patients with Obstructive Sleep Apnea: An Update on the Daytime Attentional Impairment |
| title_full_unstemmed | The Neuropsychological Profile of Attention Deficits of Patients with Obstructive Sleep Apnea: An Update on the Daytime Attentional Impairment |
| title_short | The Neuropsychological Profile of Attention Deficits of Patients with Obstructive Sleep Apnea: An Update on the Daytime Attentional Impairment |
| title_sort | neuropsychological profile of attention deficits of patients with obstructive sleep apnea an update on the daytime attentional impairment |
| topic | obstructive sleep apnea (OSA) chronic intermittent hypoxia (CIH) excessive daytime sleepiness (EDS) alertness vigilance selective attention |
| url | https://www.mdpi.com/2076-3425/10/6/325 |
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