IMPACT OF OBSTRUCTIVE SLEEP APNEA AND CPAP TREATMENT ON NEUROPSYCHOLOGICAL AND COGNITIVE FUNCTION

<bold>Introduction:</bold> Obstructive Sleep Apnea (OSA) leads to intermitent hypoxia (IH) and sleep fragmentation (SF) which may contribute to impairments in higher cognitive functions. Hypothesis: OSA patients exhibit cognitive function alterations compared with controls, and Continuous Positive Airway Pressure (CPAP) improves cognitive functions. <bold>Methods:</bold> Patients assessed in the Sleep Unit underwent nocturnal respiratory polygraphy. Neuropsychological functions and transcranial magnetic stimulation (TMS) to assess cortical excitability using the resting motor threshold (RMT) were performed. Patients meeting criteria were treated with CPAP. After 3 months of CPAP, neuropsychological functions and TMS were reassessed. <bold>Results:</bold> 33 untreated OSA patients (22 males/11 females, median age 51.6±8.7) and 17 control (10 males/7 females, median age 41.00±14.70) were included. The AHI was 48.4±24.8 vs 3.0±1.8 (OSA vs controls). Baseline differences were observed between groups in both neuropsychological and TMS assessment: a) Wechsler Memory Scale:32.5 ± 5.6 vs 36.7 ± 4.7, p= 0.01) b) Attention/conditioned vigilance: 0.36±0.02 vs 0.39±0.06, p= 0.07 c) RMT: 46±7.3 vs 42±7, p= 0.02. After CPAP treatment, OSA patients showed differences in conditioned attention/vigilance (0.4±0.06 vs 0.38±0.06, p= 0.04), Stroop test (1.6±0.41 vs 1.4±0.29, p= 0.05), and verbal fluency test (13.8±4.7 vs 15.4±0.4, p= 0.01), but no differences in RMT were observed. <bold>Conclusions:</bold> Patients with OSA exhibit neuropsychological functions impairment, and cortical hypoexcitability compared to healthy subjects. Correct CPAP treatment in OSA patients impacts neuropsychological functions but does not affect cortical excitability.