Abstract: Slide Presentations |

Impact of Continuous Positive Airway Pressure Treatment on Attention Deficit in Obstructive Sleep Apnea FREE TO VIEW

Clifford G. Risk, MD, PhD*; Jocelyn A. Winzer, MS
Author and Funding Information

Marlborough Center for Sleep Disorders, Marlborough, MA


Chest. 2004;126(4_MeetingAbstracts):785S. doi:10.1378/chest.126.4_MeetingAbstracts.785S-a
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PURPOSE:  Patients with obstructive sleep apnea (OSA) report excessive daytime sleepiness and attention impairment. This study will assess the impact of continuous positive airway pressure (CPAP) treatment on attention deficits.

METHODS:  This study included 22 adult patients who presented at a nationally accredited sleep center for evaluation of OSA. Severity of OSA was evaluated using the Epworth Sleepiness Scale (ESS), a self-report questionnaire designed to assess daytime sleepiness on a scale of 0 to 24. Attention impairment was evaluated using the Adult Self-Report Scale (ASRS) Symptom Checklist, designed to assess adult attention problems on a scale of 0 to 36. A score of 0 to 16 indicates normal attention, 17 to 23 indicates moderate attention impairment, and 24 or greater indicates severe attention impairment. Patients completed both questionnaires at baseline and following CPAP treatment.

RESULTS:  The average baseline score on ESS was 11.6 (4.0) and on ASRS was 17.4 (9.2). The average post-treatment score on ESS was 2.7 (3.6) and on ASRS was 10.4 (8.6), indicating significant change in ESS (F(1,21)=163.1, p<.0001) and ASRS (F(1,21)=24.6, p<.0001). At baseline, 12 patients had ASRS scores in the moderately to severely impaired range. Eight of these 12 patients’ ASRS scores dropped significantly to the normal range after CPAP (F(1,7)=32.3, p<.001). The other 4 patients’ ASRS did not change significantly and remained in the impaired range, despite a significant drop in ESS (F(1,3)=22.6, p=.02).

CONCLUSION:  The results of this study support a high comorbidity between attention deficit and OSA. Fifty-five percent showed significant attention impairment at baseline, but substantially improvement after CPAP treatment. However, 18% continued to report serious attention deficit following treatment. These patients were diagnosed with adult attention deficit disorder (ADD) after neuropsychological testing and required pharmacological intervention and skills training.

CLINICAL IMPLICATIONS:  Sleep specialists should be aware that even after optimal CPAP treatment of OSA, a residual cohort of patients with an attention deficit may remain who require further evaluation and treatment.

DISCLOSURE:  C.G. Risk, None.

Wednesday, October 27, 2004

10:30 AM- 12:00 PM




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