From the Guidelines
Neurological symptoms of Obstructive Sleep Apnea Syndrome (OSAS) include decreased daytime alertness, fatigue, and sleepiness. These symptoms are a result of the fragmented sleep and intermittent hypoxia associated with OSAS, which can lead to impairments in vigilance, concentration, cognitive function, and social interactions 1.
Common Neurological Symptoms
- Daytime sleepiness: a common symptom of OSAS, which can increase the risk of motor vehicle accidents and other accidents 1
- Fatigue: can be a result of the poor sleep quality associated with OSAS 1
- Decreased concentration and memory: can be affected by the fragmented sleep and intermittent hypoxia associated with OSAS 1
- Impairments in cognitive function: can be a result of the chronic sleep deprivation associated with OSAS 1
- Mood disturbances: such as depression and anxiety, can be associated with OSAS 1
Evaluation and Diagnosis
A comprehensive sleep history and physical examination are essential in evaluating patients with suspected OSAS, and should include an assessment of sleepiness severity, total sleep amount, nocturia, morning headaches, and decreased concentration and memory 1. The diagnosis of OSAS involves measuring breathing during sleep, and can be confirmed by a polysomnogram (PSG) or home sleep apnea test (HSAT) 1.
Treatment and Management
Treatment of OSAS can improve neurological symptoms, and may include the use of continuous positive airway pressure (CPAP) therapy, oral appliance therapy (OAT), or surgery 1. Mandibular advancement devices (MAD) are a type of OAT that can be effective in reducing symptoms of OSAS, and can be used in patients with mild to moderate OSAS, or in those who are unable to tolerate CPAP therapy 1.
From the Research
Neurological Symptoms of Obstructive Sleep Apnea Syndrome (OSAS)
The neurological symptoms of OSAS are varied and can have a significant impact on an individual's quality of life. Some of the key symptoms include:
- Cognitive impairment, particularly in the domains of attention, memory, and executive functions 2, 3
- Increased risk of neurodegenerative diseases, such as Alzheimer's disease and Parkinson's disease 2
- Seizures, which can be induced by sleep disruption and deprivation, as well as cerebral hypoxemia 2
- Headaches, including a specific type of headache known as "sleep apnea headache" 2, 4
- Stroke, which can be caused by the endothelial dysfunction and formation of atherosclerosis resulting from hypoxia 2
- Impaired concentration and reduced quality of life 5
- Vigilance impairment and neuropsychological deficits, which can be attributed to nocturnal hypoxemia and sleep disruption 6
Treatment and Management
Treatment of OSAS can help to alleviate some of the neurological symptoms associated with the condition. Continuous positive airway pressure (CPAP) therapy is the most effective and widely used treatment for OSAS, and can help to: