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 Researchers found that people using continuous positive airway
pressure (CPAP) to treat apnea, but who still complained of daytime
sleepiness, also had problems with certain thinking skills.
"These individuals do not respond to treatment, and eventually will
drop CPAP because they do not feel better,” said lead study author
Ksdy Werli of the Federal University of Sao Paulo in Brazil.
“We chose to study this issue aiming to understand the real
difficulties of these patients,” Werli said by email.
More than 18 million U.S. adults have sleep apnea, a condition that
causes people to wake up repeatedly throughout the night as their
airways collapse and they cannot breathe, according to the National
Sleep Foundation.
One of the most common symptoms of untreated sleep apnea is daytime
sleepiness as a result of sleep that is disrupted dozens of times a
night and possibly of oxygen deprivation. CPAP is a standard
treatment designed to keep airways open to allow a sleeper to
breathe normally.
Even when CPAP works well, though, some patients continue to
experience excessive sleepiness during the day, Werli’s team writes
in the journal Sleep Medicine.
Between 6 percent and 34 percent of patients continue to experience
daytime sleepiness after treatment and experts don’t know why this
occurs, Werli told Reuters Health.
To understand what other problems this might cause, the study team
collected data on 15 patients, ranging in age from 35 to 60 years
old, who had been treated with CPAP but still felt sleepy during the
day.
The study team also recruited a comparison group of 15 people with
sleep apnea using CPAP and reporting no lingering sleepiness.
The research team tested participants to assess their brain
function, including attention, memory and judgment. They also
screened participants for depression symptoms because depression can
negatively affect mental functions like memory and motivation.
Overall, the people complaining of sleepiness had higher average
scores on depression tests. But there was little difference between
groups on long-term memory tests.
The people experiencing sleepiness had the greatest trouble with
so-called executive functions, which can include attention,
motivation, problem-solving and planning.
In particular, these participants struggled problem-solving skills
and with a verbal fluency test that measures strategic thinking and
organization of words. They did not display differences from the
comparison group in other functions including attention and number
memory.
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Researchers found that having more depression symptoms was linked to
poorer performance on verbal fluency tests, but depression didn’t
explain any of the other results.
Werli noted that the brain functions affected by sleepiness like
judgment, criticism and planning are important for helping people
adapt to their environment and deal with new situations.
If you have sleep apnea and were effectively treated but you are
still sleepy, "you may be at risk for accidents and lower mental
performance," Werli said.
This reduced brain function negatively impacts all aspects of daily
living, including work, driving performance, social life and
relationships, said Renaud Tamisier of Grenoble Alps University in
France, who was not involved in the study.
“Sleepiness is really a symptom people do not want to live with,”
Tamisier told Reuters Health by email.
It is important to identify diseases that affect quality of sleep,
but people should also examine their lifestyle to find ways to
improve their sleep, Tamisier added.
If the treatment of a sleep disorder is not enough, people can try
using sleep hygiene techniques like avoiding napping during the day
and not consuming caffeine to close to bedtime, Werli said.
“If a patient has excessive daytime sleepiness and has not yet been
diagnosed with a sleep disorder, they should see a doctor to
investigate the causes of drowsiness,” Werli said.
SOURCE: bit.ly/2dRlYXd Sleep Medicine, online October 6, 2016.
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