CPAP therapy and its effect

In various studies improved performance under nCPAP therapy have be determined regarding to changes in neuropsychological parameters and/or test performance. Lamphere et al. (1989) could be shown that after one therapy night there was a significant improvement of the attention, which normalized after 14 days of nCPAP. In several studies it could be detected also a reduction in both subjective and objective daytime sleepiness (Montplaisir et al. 1992, Engleman et al. 1993, 1994, Douglas et al. 2000 - according to Schwarzenberg-Kesper et al. (1987) is the improvement of daytime sleepiness an essential motif for a good therapeutic compliance of the patients). Sforza et al. (1995) found after one year of nCPAP treatment an objectively reduced daytime sleepiness, which increased again after a night of therapy interruption. In several studies could be verified also improved further neuropsychological deficits. Kotterba et al. (1998) reported a significant improvement in the simple attention as well as the divided attention, in the cognitive performance and the processing speed. The latter could be replicated also by Büttner et al. (2007). Even an improvement of vigilance or sustained attention, and various cognitive deficits due to the nCPAP therapy was described many times (Denzel et al. 1993, Engleman et al. 1994, Randerath 1997, 2000, Büttner 1999).

Other studies have shown, however, that the cognitive and neuropsychological deficits don't increase or only improving in certain areas, which could indicate an irreversible hypoxic damage of the CNS (Montplaisir et al. 1992, Bedard et al. 1993, Kotterba et al. 1998) and thus point up the importance of early diagnosis and treatment of OSAS underscores.

Conclusion

The difference or the improvement after effective nCPAP therapy suggests the need to use this therapy in OSAS patients, possibly to avoid serious impairment in the memory processes and in cognitive performance or to allow the patient not to suffer under the daytime consequences of Sleep Apnea Syndrome.

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