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. 2020 Mar 9:12:183-195.
doi: 10.2147/NSS.S234310. eCollection 2020.

Psychomotor Performance in Patients with Obstructive Sleep Apnea Syndrome

Linda Lusic Kalcina  1 , Ivana Pavlinac Dodig  1 , Renata Pecotic  1 , Maja Valic  1 , Zoran Dogas  1
Affiliations

Psychomotor Performance in Patients with Obstructive Sleep Apnea Syndrome

Linda Lusic Kalcina et al. Nat Sci Sleep. .

Abstract

Purpose: Determinants of obstructive sleep apnea (OSA) are hypoxemia and hypercapnia, as well as (micro) arousals from sleep, resulting in chronic sleep fragmentation, sleep deprivation, and excessive daytime sleepiness (EDS). All of the above-mentioned factors might contribute to psychomotor impairment seen in OSA patients. Additionally, this study aimed to assess the contribution of BMI, age, EDS assessed with Epworth sleepiness scale (ESS), and severity of OSA assessed with apnea-hypopnea index (AHI) to the reaction time on chronometric tests in OSA patients and controls. It is hypothesized that moderate and severe OSA have adverse effects on reaction time of perception to visual stimulus, of solving simple arithmetic operations, and of psychomotor limbs coordination assessed by chronometric psychodiagnostic test battery.

Patients and methods: This study was conducted on 206 male participants; 103 of them had moderate or severe OSA diagnosed by whole-night polysomnography/polygraphy. Control participants (N=103), matched to patients with OSA by age and BMI, had no reported OSA in their medical history, no increased risk for OSA, nor EDS. All participants were assessed with three chronometric psychodiagnostic tests, measuring the reaction time of perception to visual stimulus, of solving simple arithmetic operations, and of psychomotor limbs coordination.

Results: Participants from the OSA group achieved impaired results compared to control participants in minimum single task solving time in speed of solving simple arithmetic operations (3±0.9 and 2.6±0.6, P<0.001), and in minimum solving time of a single task in complex psychomotor limbs coordination (0.69±0.2 and 0.61±0.1, P=0.007). Regression analysis revealed no significant contribution of daytime sleepiness to the results achieved in each of the tests.

Conclusion: It is concluded that severe OSA impaired speed of perception, convergent, and operative thinking. Moreover, it is suggested that EDS did not contribute to poor psychomotor outcome in patients with OSA in this study, when age was controlled for.

Keywords: daytime sleepiness; obstructive sleep apnea syndrome; overnight polysomnography; psychodiagnostic test; psychomotor performance.

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Conflict of interest statement

The authors declare they have no conflict of interest. No competing interests were reported by the authors for any financial interests or commercial associations held by the authors or their family members.

Figures

Figure 1
Figure 1
Correlation between speed of perception to visual stimulus and AHI index of patients with OSA. Notes: The scatter plot represents the association of a total test solving time needed to perform the perception to visual stimulus test and the severity of apnea expressed as AHI (r=0.256; P=0.011). Abbreviations: CRD 311, test of speed of perception to visual stimulus; AHI, apnea hypopnea index; TTST, total test solving time.
Figure 2
Figure 2
Total and minimal psychomotor reaction time of obstructive sleep apnea patients (n=103) and controls (n=103), divided at age groups. Notes: Average minimum solving time of a single task and total test solving time for all three psychomotor tests (test of speed of perception to visual stimulus, test of speed of solving simple arithmetic operations, test of psychomotor limbs coordination) of patients with OSA (n=103) and control (n=103) subjects, divided at age groups. Solid lines are showing the reference range of test results in healthy subjects, dotted lines are showing the average test results for patients with OSA and dashed lines are showing the average test results for control subjects. Asterisk (*) indicates a significant difference with P<0.05 among OSA patients and controls of a single age group in a specific chronometric measure following t-test for independent samples. Abbreviations: TTST, total test solving time; MinT, minimum solving time of a single task.
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Grants and funding

Croatian Science Foundation (HRZZ) supported this research via grant TIHO2_SLEEP_BREATH 5935, which was obtained by Professor Zoran Dogas.

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