The Therapeutic Effects of two-month Positive Airway Pressure on Cognitive Functions in Patients with Obesity Hypoventilation Syndrome

• Main Authors: KUNG, SHU-CHIN, 龔書槿
• Other Authors: SHEN, YU-CHIH
• Format: Others
• Language: zh-TW
• Published: 2017
• Online Access: http://ndltd.ncl.edu.tw/handle/zhr546

碩士 === 慈濟大學 === 人類發展與心理學系碩士班 === 105 === Obstructive sleep apnea (OSA) is the most common type of adult sleep apnea.It would cause repeated nocturnal desaturation and sleep fragmentation, may influence several aspects of cognitive function.10% to 15% of obesity OSA patients combine hypercapnia and meet the criteria with obesity hypoventilation syndrome (OHS).The treatment of OSA is to wear a positive airway pressure (PAP), with air pressure to keep airway unimpeded during sleep and reduce PaCO2. Currently, the studies of obesity, hypercapnia or the PAP effects on cognitive functions in OSA patients are controversial. This study explores the changes of cognitive function in patients with OSA after 2-month PAP intervention.81 patients with moderate to severe OSA were enrolled in this study and completed the pre-test, 41 obesity OSA and 40 non-obesity OSA. In obesity OSA group, 17 subjects are combined with hypercapnia and 24 subjects are without hypercapnia.60 patients completed the study,17 patients refused for PAP (control group) and 43 patients were assigned to receive PAP treatment period (PAP group).we divided PAP group into obesity group(23 patients) and non-obesity group (20 patients) and divided obesity group into hypercapina group(13 patients) and non-hypercapina group(10 patients). Cognitive functions are including memory, executive function and attention which are evaluated by Psychomotor Vigilance Test (PVT), flanker task, stroop task and Digit Symbol Substitution Test, Digit span, WAIS Memory Test(WMS-III-Faces subtestand WMS-III-logic memory subtest). Sleep quality are evaluated by Epsworth Sleepiness Scale(ESS) and Pittsburgh Sleep Quality Rating Scale (PSQI). In baseline, obesity OSA group are significant impact in the delayed verbal memory and PVT response time. Hypercapnia group patients compared with non-hypercapnia group were significantly impact in working memory, immediate and delay verbal memory, immediate visual memory, executive function and attention of the cognitive function. After intervention of PAP treatment, we divided the obesity group into hypercapnia and non-hypercapnia groups and corrected the baseline scores using ANCOVA analysis. Obesity group and non-obesity are both improved in the delay verbal memory and executive function. Obesity with non-hypercapnia group demonstrated a significant therapeutic effect in the information processing speed, verbal memory, executive function and PVT. Obesity with hypercapnia group was significantly improved in verbal memory, visual memory and executive function after two-month intervention. Our study demonstrated that obesity and hypercapnia cause significantly impact in the cognitive function and the positive effects of PAP on some cognitive functions in OSA patients after two-month intervention.