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Moderate and severe OSA in males impair psychomotor reaction times assessed by CRD- series testing

Obstructive sleep apnoea (OSA) is characterized by repetitive transient obstructions of the upper airway, which result in cessations of the airflow and consequently lead to hypoxemia and hypercapnia. Apart from the hypoxemia, each obstructive event in apnoeic patients is also accompanied by (micro) arousals from sleep, resulting in chronic sleep fragmentation, sleep deprivation and consequent excessive daytime sleepiness (EDS). All of the above mentioned factors might be proposed as mechanisms underlying cognitive impairment seen in OSA patients, mostly in areas of general intellectual functioning, memory, reasoning, executive and motor functioning, psychomotor speed, visuospatial functions, attention and vigilance, concept formation, construction, perception, attention and alertness. We hypothesize that moderate and severe OSA have adverse effects on reaction times on visual stimuli, simple arithmetic tasks, and complex psychomotor limbs coordination assessed by the computer-based psychomotor CRD-series tests. This study was conducted on 206 male subjects ; 103 of them had moderate or severe OSA diagnosed by whole-night polysomnography/polygraphy. Control subjects (N=103), matched to OSA subjects by gender, age and BMI, had no recorded OSA in their medical history, no increased risk for OSA measured by STOP and STOP-BANG questionnaires, nor ESD measured by Epworth Sleepiness Scale (ESS) score. All subjects in a random order solved three tests from CRD-series, which measured speed of visual perception (CRD311), convergent thinking during solving simple arithmetic operations (CRD11), and operative thinking during tasks that required complex psychomotor limbs coordination (CRD411). In each of the applied tests total test solving time (TTST), minimum (best) single task solving time (MinT), and median time for task solving (MedT) were recorded. We conclude that moderate and severe OSA impaired reaction times of visual perception, convergent thinking during solving simple arithmetic operations, and operative thinking during tasks that required complex psychomotor limbs coordination. Moreover, we propose that EDS was not the underlying mechanism by which OSA produced these negative effects on cognitive outcome in our study.

OSA, sleep, psychomotor

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