Patients with sleep disorders report excessive daytime fatigue, sleepiness, and attention impairment. This study will assess the impact of sleep disorders (other than sleep apnea) on the attention deficit disorder in patients who present with a wide spectrum of comorbid neuromuscular disorders, psychological disorders, auditory or reading impairments, learning impairments, executive function impairments, and organicity.
This study included 64 adult patients who presented to a nationally accredited sleep center for the evaluation of a slepe disorder other than obstructive sleep apnea. Scores were obtained for the degree of attention deficit, insomnia, excessive daytime sleepiness, anxiety, depression, fatigue, and pain, using standard scales of measuring severity. Neuropsyhcological testing of memory and learning was perfomred on a subset of these patients.
Presenting comorbid diagnoses were as follows: Neuromuscular disease (16), anxiety and mood disorders (22), auditory or reading deficits (5), impaired executive function or memory impairment (15), organic brain injury (6).Sleep diagnoses were as follows: Insomnia (50), hypersomnia (2), periodic limb movements of sleep (2), REM behavior disorder (1), sleep terrors (1), fatigue/non-restorative sleep (8).Attention deficit was presented in 57 patients (90%), and strongly correlated with the severity of insomnia, anxiety and depression; auditory or reading deficits; memory or learning impairments; and organicity.Neuropsychological testing demonstrated significant impairments in auditory and visual learning and memory. Goal directed therapy undertaken in 15 patients, successfully decreased their attention deficit to the normal range.
Sleep disorders other than obstructive sleep apnea have a strong impact on the presence of the attention deficit disorder in the adult. The slepe disorder and the comorbid contributing disorder must both be evaluated and treated to improve the daytime attention deficit disorder.
Sleep specialists should be aware that evaluation and treatment of insomnia and of other slepe disorders requires concurrent assessment of comorbid diagnoses that contribute to the attention deficit presentation. This is best achieved by a multidisciplinary medical model.
Clifford Risk, None.