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Executive function in sleep apnea: controlling for attentional capacity in assessing executive attention.
Sleep 2004; 27(4):685-93S

Abstract

STUDY OBJECTIVES

As the effects of general slowness and decreased attentional capacity on higher executive attention have not been fully taken into account in the sleep apnea literature, we statistically controlled for basic attentional performance in evaluating executive attention per se in sleep apnea patients.

DESIGN

A case-controlled design was used with comparison of basic and executive attentional tasks.

PARTICIPANTS

Thirty-six polysomnographically diagnosed patients (mean apnea-hypopnea index = 60.5 +/- SD 31.6) participated, together with 32 healthy controls.

MEASUREMENTS AND RESULTS

Neuropsychological tests included Trail Making part A and B, Symbol Digit Modalities (SDMT), Digit Span forward and backward, Stroop Color-Word, Five-Point design fluency, and an Attentional Flexibility task. Patients' vigilance data indicated time-on-task decrements after 10 minutes. Moreover, their performance was significantly reduced on the SDMT (effect size d = 0.93), the Digit Span forward task (d = 0.44), the number of errors on the basic 2-choice reaction time subtest of the Attentional Flexibility task (d = 0.74) and the mean RT on the actual Attentional Flexibility subtest (d = 0.54). It has been argued that the latter poor performance was probably primarily related to the task's phonologic loop component of working memory rather than to an attentional switching deficit per se. No other performance differences were found between patients and healthy controls.

CONCLUSIONS

In addition to vigilance decrements, attentional capacity deficits clearly emerge, ie, slowed information processing and decreased short-term memory span. However, no specific clinical indications for executive attentional deficits--such as disinhibition, distractibility, perseveration, attentional switching dysfunction, decreased design fluency, or an impaired central executive of working memory--are found in patients with severe sleep apnea. Their cognitive performance seems very similar to the cognitive decline found after sleep loss and qualitatively different from patients with chronic obstructive pulmonary disease, suggesting sleepiness as the primary factor in a parsimonious explanation for the attention deficits in sleep apnea, without the need to assume prefrontal brain damage.

Authors+Show Affiliations

Department of Cognitive and Physiological Psychology, Lab for CAS Research: Cognition, Neuropsychology & Sleep, Vrije Universiteit/Free University Brussels, Belgium. edwin.verstraeten@vub.ac.beNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15283003

Citation

Verstraeten, Edwin, et al. "Executive Function in Sleep Apnea: Controlling for Attentional Capacity in Assessing Executive Attention." Sleep, vol. 27, no. 4, 2004, pp. 685-93.
Verstraeten E, Cluydts R, Pevernagie D, et al. Executive function in sleep apnea: controlling for attentional capacity in assessing executive attention. Sleep. 2004;27(4):685-93.
Verstraeten, E., Cluydts, R., Pevernagie, D., & Hoffmann, G. (2004). Executive function in sleep apnea: controlling for attentional capacity in assessing executive attention. Sleep, 27(4), pp. 685-93.
Verstraeten E, et al. Executive Function in Sleep Apnea: Controlling for Attentional Capacity in Assessing Executive Attention. Sleep. 2004 Jun 15;27(4):685-93. PubMed PMID: 15283003.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Executive function in sleep apnea: controlling for attentional capacity in assessing executive attention. AU - Verstraeten,Edwin, AU - Cluydts,Raymond, AU - Pevernagie,Dirk, AU - Hoffmann,Guy, PY - 2004/7/31/pubmed PY - 2004/10/22/medline PY - 2004/7/31/entrez SP - 685 EP - 93 JF - Sleep JO - Sleep VL - 27 IS - 4 N2 - STUDY OBJECTIVES: As the effects of general slowness and decreased attentional capacity on higher executive attention have not been fully taken into account in the sleep apnea literature, we statistically controlled for basic attentional performance in evaluating executive attention per se in sleep apnea patients. DESIGN: A case-controlled design was used with comparison of basic and executive attentional tasks. PARTICIPANTS: Thirty-six polysomnographically diagnosed patients (mean apnea-hypopnea index = 60.5 +/- SD 31.6) participated, together with 32 healthy controls. MEASUREMENTS AND RESULTS: Neuropsychological tests included Trail Making part A and B, Symbol Digit Modalities (SDMT), Digit Span forward and backward, Stroop Color-Word, Five-Point design fluency, and an Attentional Flexibility task. Patients' vigilance data indicated time-on-task decrements after 10 minutes. Moreover, their performance was significantly reduced on the SDMT (effect size d = 0.93), the Digit Span forward task (d = 0.44), the number of errors on the basic 2-choice reaction time subtest of the Attentional Flexibility task (d = 0.74) and the mean RT on the actual Attentional Flexibility subtest (d = 0.54). It has been argued that the latter poor performance was probably primarily related to the task's phonologic loop component of working memory rather than to an attentional switching deficit per se. No other performance differences were found between patients and healthy controls. CONCLUSIONS: In addition to vigilance decrements, attentional capacity deficits clearly emerge, ie, slowed information processing and decreased short-term memory span. However, no specific clinical indications for executive attentional deficits--such as disinhibition, distractibility, perseveration, attentional switching dysfunction, decreased design fluency, or an impaired central executive of working memory--are found in patients with severe sleep apnea. Their cognitive performance seems very similar to the cognitive decline found after sleep loss and qualitatively different from patients with chronic obstructive pulmonary disease, suggesting sleepiness as the primary factor in a parsimonious explanation for the attention deficits in sleep apnea, without the need to assume prefrontal brain damage. SN - 0161-8105 UR - https://www.unboundmedicine.com/medline/citation/15283003/Executive_function_in_sleep_apnea:_controlling_for_attentional_capacity_in_assessing_executive_attention_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=15283003.ui DB - PRIME DP - Unbound Medicine ER -