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Article #70

Neuropsychological Function

in Obstructive Sleep Apnoea

Heather Engleman and David Joffe

Edinburgh Sleep Center, Royal Infimary of Edinburgh

Published in Sleep Medicine Vol.3(1), pp 59-78, 1999

SUMMARY

This article reviews current findings on the issue of mental impairments associated with sleep apnea. Tests show mild to moderate impairment in a variety of functions, including (among others) attention, concentration, memory, and problem-solving.

These impairments, along with the sleepiness associated with sleep apnea, may cause the increased risk of auto accidents in people with sleep apnea. This risk has been estimated as twice to seven times that of people without sleep apnea.

Both nighttime arousals and reduced blood oxygen to the brain may contribute to these impairments. CPAP improves these problems, but may not restore them to normal.

The severity of the apnea is related moderately to the severity of mental impairment and mildly to the severity of sleepiness.

COMMENTS

This should be a subject of great concern to people with sleep apnea and their families. It is one thing to be uncomfortably sleepy; it is another thing to be unable to function up to par in critical areas of life like driving a car. Anyone who might have reason to suspect themselves of having sleep apnea, but might not want to undergo testing for it, or might think they could "live with" the disorder untreated, should consider that jobs and lives may be at stake.

Equally important, those of us who suffer from the disease must take an active part in making our own needs and concerns known. The drunken driver involved in an accident may lose his license and even go to prison; so may the person with sleep apnea, it seems. But there is no such easy way of determining impairment from sleep apnea as a breathalyzer test to determine the level of alcohol intoxication.

If you lose your driver's license, as I have, because of sleep apnea, how will you manage? And how will you or your doctor or the Department of Motor Vehicles in your state know when you have recovered enought to drive safely again?

One Reader's Reaction

I can say that my life--and that of my children--although they don't know it--was seriously at risk until I was diagnosed. I became divorced around the same time I became a "serious" sleep apnea patient. My indices registered a 72. My doctor said I was the worse candidate he had seen in his entire life.

Because I was divorced I had to travel large distances to be with my children. It wasn't until I saw the telephone poll directly in front of my truck on my son's side that I realized something was wrong with me.

It took several weeks to get diagnosed and during those few weeks there were so many instances where I thought we would never make it. I reached a point where I could not travel more than a half hour without pulling over for sleep.

Even though I supposedly slept all night when I took these little naps I would be out for four hours and not know it until I woke up--but I was still tired.

Getting treatment saved my life, my children's and perhaps some innocent driver on the same road.

If you have any experiences or ideas relating this article or my comments on it, please E-mail me (and mention the article you are commenting on--"#70: Neuropsych") at


kleonwhitemd@mindspring.com

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