Cerebral perfusion is not impaired in persons with moderate obstructive sleep apnoea when awake.

PURPOSE: It is well established that, together with a multitude of other adverse effects on health, severe obstructive sleep apnoea causes reduced cerebral perfusion and, in turn, reduced cerebral function. Less clear is the impact of moderate obstructive sleep apnoea (OSA). Our aim was to determine if cerebral blood flow is impaired in people diagnosed with moderate OSA. METHODS: Twenty-four patients diagnosed with moderate OSA (15 ≤ apnoea-hypopnea index (AHI) < 30) were recruited (aged 32-72, median 59 years, 10 female). Seven controls (aged 42-73 years, median 62 years, 4 female) with an AHI < 5 were also recruited. The OSA status of all participants was confirmed at baseline by unattended polysomnography and they had an MRI arterial-spin-labelling scan of cerebral perfusion. RESULTS: Neither global perfusion nor voxel-wise perfusion differed significantly between the moderate-OSA and control groups. We also compared the average perfusion across three regional clusters, which had been found in a previous study to have significant perfusion differences with moderate-severe OSA versus control, and found no significant difference in perfusion between the two groups. The perfusions were also very close, with means of 50.2 and 51.8 mL/100 g/min for the moderate-OSAs and controls, respectively, with a negligible effect size (Cohen's d = 0.10). CONCLUSION: We conclude that cerebral perfusion is not impaired in people with moderate OSA and that cerebral flow regulatory mechanisms can cope with the adverse effects which occur in moderate OSA. This is an important factor in clinical decisions for prescription of continuous positive airway pressure therapy (CPAP).

Attention lapses and behavioural microsleeps during tracking, psychomotor vigilance, and dual tasks.

This study examined the incidence of attention lapses and microsleeps under contrasting levels of task complexity during three tasks: PVT, 2-D tracking and a dual task combining the two. More attention lapses per participant (median 15vs. 3; range 1-74vs. 0-76, p=0.001), with the greatest increase with time spent-on-task (p=0.002), were evident on the more cognitively-demanding dual task than on the PVT. Conversely, fewer microsleeps (median 0vs. 0; range 0-1vs. 0-18, p=0.022) occurred during the more complex task compared to the tracking task. An increase in microsleep rate with time spent-on-task (p=0.035) was evident during the tracking task but not the dual task. These results indicate that the higher cognitive load, associated with an increase in task complexity, increased the likelihood of attention lapses, while a reduction in task complexity increased the likelihood of microsleeps.