Metamemory beliefs and episodic memory in obstructive sleep apnea syndrome

This study assessed metamemory and its role in actual episodic memory performance in 26 patients with obstructive sleep apnea syndrome and 27 healthy controls. Metamemory knowledge and memory beliefs were assessed using the Metamemory Inventory in Adulthood. Episodic memory performance was investigated with the Remember/Know paradigm. Subjective sleepiness was evaluated. Patients underwent a polysomnographic assessment. In contrast to the control group's more stable memory beliefs, patients self-assessed their memory as declining across time, and felt more anxious about their memory. There was only a modest difference between patients' self-perceptions of their memory capacities and those of the control group, but patients' actual memory performance was strongly disturbed. While the latter was significantly correlated with severity of obstructive sleep apnea, scores on the Metamemory Inventory in Adulthood scales were not correlated with physiological measures, subjective sleepiness, or episodic memory performance. Obstructive sleep apnea may affect prefrontal cortex functioning and hence the ability to assess one's own memory impairment.     

Psychological morbidity, illness representations, and quality of life in female and male patients with obstructive sleep apnea syndrome

Obstructive sleep apnea syndrome (OSAS) is a sleep-related breathing disorder that affects both women and men. The aim of this study was to characterize and investigate the differences in terms of anxiety, depression, illness perception, and quality of life between female and male OSAS patients from a total of 111 patients (33 women and 78 men) who were recently diagnosed with OSAS in an outpatient clinic of a University Hospital in Portugal. They underwent a standardized protocol that included evaluation to assess of psychological morbidity (anxiety and depression - Hospital Anxiety and Depression Scale), illness representations (Brief Illness Perception Questionnaire), and quality of life (Sleep Apnea Quality of Life Index). The most significant differences between female and male OSAS patients result of apnea/hypopnea index (AHI), after controlling for body mass index (p?相似文献   

Integrating Sleep Management into Clinical Practice

Although the basic function of sleep remains a mystery, insufficient sleep is associated with mood disturbance, fatigue and daytime lethargy, cognitive impairments, daytime behavior problems, academic problems, use of stimulants, work absenteeism, lost work production and an increase in healthcare utilization. The International Classification of Sleep Disorders distinguishes 90 different disorders, many of which can be effectively treated, but when left untreated can be costly in terms of quality of life, health and healthcare cost. Over the past 50 years we have become more effective in measuring sleep and have honed our treatments to better address the sleep disorders that most impact us. This article will focus on the three sleep disorders for which patients most frequently seek care, including insomnia, obstructive sleep apnea syndrome and restless leg syndrome.     

Adult ADHD and/or Sleep Apnea? Differential Diagnostic Considerations with Six Case Studies

An increased interest in the persistence of attention-deficit hyperactivity disorder (ADHD) into adulthood brings concern that adult ADHD may become overdiagnosed. As with ADHD in childhood, various other adult psychological and medical disorders may be associated with ADHD in adulthood, and these related disorders may be mislabeled and mistreated as simple ADHD. One such medical condition is sleep apnea. This paper reviews similarities and differences between ADHD and sleep apnea and presents case histories of six adult patients diagnosed with ADHD who were subsequently found to have at least comorbid obstructive sleep apnea (OSA). Clinicians who diagnose and treat patients with ADHD are advised to become familiar with sleep apnea as a life-threatening condition that presents with overlapping symptoms.     

糖尿病与睡眠的相互关系

人一生中有1／3的时间在睡眠中度过,睡眠质量直接关系到一个人的身体健康。睡眠时间过少或过多的人糖尿病患病率大大增加。糖尿病本身的病理、生理特点,严重影响患者的睡眠质量,睡眠质量又可以反过来影响糖尿病患者的血糖水平。有研究显示,糖尿病患者最佳睡眠时间为8小时。同时糖尿病患者中睡眠呼吸暂停综合征（OSAS）患病率高,0SA...     

睡眠呼吸暂停相关性高血压

睡眠呼吸暂停综合征是以睡眠过程中反复呼吸暂停进而引起慢性间歇性低氧、二氧化碳潴留为特征的常见睡眠呼吸障碍性疾病。阻塞性睡眠呼吸暂停与高血压密切相关,睡眠呼吸暂停相关性高血压为一常见的特殊患病人群,多导睡眠图是诊断睡眠呼吸暂停相关性高血压的“金标准”,其治疗在一般生活方式改变基础上,持续气道正压通气治疗是其重要治疗方法。     

Television Exposure,Sleep Time,and Neuropsychological Function Among Preschoolers

We explored whether sleep time mediates the relation between preschoolers' television exposure and two indicators of neuropsychological function: executive function (EF) and theory of mind (ToM). With a sample of 107 preschoolers and their parents, we found that heavier background television exposure and nighttime television viewing were related to fewer hours of sleep, which, in turn, was related to weaker ToM. However, sleep time did not mediate the relation between intentional television viewing and EF. In this article, we discuss the importance of understanding the mechanisms by which television exposure can affect children's neuropsychological function and offer several alternative explanations.     

Insomnia: Neurophysiological and NeuropsychologicalApproaches

Insomnia is a symptom, a syndrome and a comorbid disorder. Its diagnosis relies on subjective reports from the afflicted individual and is defined as difficulties in initiating sleep, maintaining sleep, waking up too early or non-restorative sleep. However, insomnia and especially, primary insomnia, has received much attention in insomnia research with the use of objective measures. Insomnia, its peculiarities, most frequent subtypes and two most prominent models will first be briefly introduced. Then, insomnia will be reviewed according to results obtained with the use of neurophysiological measures as basic/traditional as polysomnography to more sophisticated ones such as power spectral analysis, neuroimaging, cyclic alternating patterns and event-related potentials. In addition, a review of the discrepancies between subjective and objective reports of cognitive alterations through neuropsychological testing is offered. The need to combine measures is then highlighted in conclusion.     

Sleep imaging and the neuro-psychological assessment of dreams

Recent neuroimaging studies show that human rapid-eye-movement (REM) sleep is characterized by a specific pattern of regional brain activity. Although this is usually interpreted in relation to physiological and cellular mechanisms, the specific regional distribution of brain activity during REM sleep might also be linked to specific dream features. Remarkably, several bizarre features of normal dreams have similarities with well-known neuropsychological syndromes after brain damage, such as delusional misidentifications for faces and places. We propose that neuropsychological analysis of dream content might offer new ways of interpreting neuroimaging maps of sleep, and make specific predictions for future neuroimaging studies.     

Obstructive Sleep Apnea Syndrome in Prader-Willi Syndrome: An Unrecognized and Untreated Cause of Cognitive and Behavioral Deficits?

Prader-Willi Syndrome (PWS) is a rare genetic disorder characterized by a range of physical, psychological, and physiological abnormalities. It is also distinguished by the high prevalence of obstructive sleep apnea syndrome (OSAS), i.e., repetitive upper airway collapse during sleep resulting in hypoxia and sleep fragmentation. In non-PWS populations, OSAS is associated with a range of neurocognitive and psychosocial deficits. Importantly, these deficits are at least partly reversible following treatment. Given the findings in non-PWS populations, it is possible that OSAS may contribute to neurocognitive and psychosocial deficits in PWS. The present review examines this possibility. While acknowledging a primary contribution from the primary genetic abnormality to central neural dysfunction in PWS, we conclude that OSAS may be an important secondary contributing factor to reduced neurocognitive and psychosocial performance. Treatment of OSAS may have potential benefits in improving neurocognitive performance and behavior in PWS, but this awaits confirmatory investigation.     

Hypersomnia and the perception of sleep-wake states: some preliminary findings

35 hypersomniacs (20 with obstructive sleep apnea and 15 with narcolepsy) and 15 controls estimated sleep latency during systematic trials of attempting to remain awake during the day. The error in subjective assessment of sleep latency was more variable for both patient groups than for controls. In addition, narcoleptics could not provide a determination of sleep latency or differentiate sleep-wake states on nearly 23% of all trials. Ratings on a subjective sleepiness scale did not covary with objective sleep latency for any hypersomniac. The findings suggested that patients with either sleep apnea or narcolepsy had difficulty differentiating sleep and quiet wakefulness during the day.     

Quantitative Electroencephalography (QEEG) and Neuropsychological Syndrome Analysis

The ideographic, syndrome analysis and the nomothetic, standardized test battery approaches to neuropsychological assessment are compared and contrasted within the context of advances in noninvasive technology readily available for use within the examiner's office. By demonstrating the relative strengths and benefits of syndrome analysis, it is suggested that this approach provides a thorough and efficient method of neuropsychological assessment. Subsequently, the utility of an a priori hypothesis testing process approach as a critical technique in syndrome analysis will be supported. It will be proposed that QEEG procedures provide a useful method for further substantiating conclusions generated from a syndrome analysis approach to neuropsychological assessment. Two cases are described demonstrating the utility and flexibility of the QEEG as a confirmatory test of localization following syndrome analysis. In summary, the contributions that neuropsychologists make to the understanding of brain–behavior relationships may be strengthened by combining neuropsychological and neurophysiological assessment methods.     

Parkinson’s Disease as a Disconnection Syndrome

Parkinson’s disease (PD) is a major neurodegenerative disorder that is usually considered in terms of midbrain and basal ganglia dysfunction. Regarding PD instead as a disconnection syndrome may prove beneficial to understanding aspects of cognition, perception, and other neuropsychological domains in the disease. PD is usually of unilateral onset, providing evidence of intrahemispheric dissociations and an imbalance in the usual relative strengths of the right and left hemispheres. Hence, in order to appreciate the neuropsychology of PD, it is important to apply to this disease our understanding of hemispheric lateralization effects and within-hemisphere circuitry from brainstem to higher-order association cortex. The focus of this review is on the relevance of PD-related disconnections among subcortical and cortical structures to cognition, perception, emotion, and associated brainstem-based domains such as sleep and mood disturbance. Besides providing information on disease characteristics, regarding PD as a disconnection syndrome allows us to more completely understand normal brain-behavior relations in general.     

OSAHS在2型糖尿病发病中的作用与对策

阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea hypopnea syndrome,OSAHS）是一种常见的睡眠呼吸紊乱性疾病,以睡眠时反复发作的上气道部分或完全阻塞为特征。近年发现OSAHS与2型糖尿病之间有着明显的相关性,二者均为心血管疾病的高危因素,合并存在能够严重影响生命质量与预期寿命...     

Obstructive sleep apnea syndrome: autobiographical memory predicts the course of depressive affect after nCPAP therapy

Although nCPAP therapy has proven to be efficient at removing symptoms of obstructive sleep apnea syndrome (OSAS), recovery from depression frequently remains unsatisfactory. Other studies have shown that recall of autobiographical memories (AM) is a psychological vulnerability marker for depression, and also have shown its predictive power for the course of depression. It is therefore hypothesized that AM also predict the course of depressive affect in OSAS patients. Fifty-four consecutively admitted OSAS patients received standard nCPAP therapy. Specificity of AM assessed at the beginning of treatment was used as a predictor in a regression analysis, and the extent of recovery from depression over a follow-up period of between six to nine weeks served as the criterion variable. The results supported the hypothesis that patients who were able to recall more specific AM in response to positively valenced cue words showed a more substantial recovery from depression. This has important treatment implications.     

Neuropsychological consequences of right thalamic haemorrhage: case study and review

The neuropsychological performance of a right-handed man is examined following haemorrhage from the anterior sections of the right thalamus. A pattern of temporally graded retrograde amnesia, global anterograde amnesia, impaired short-term memory, behavioural changes, and severe executive deficits were identified. The deficits evident in this case are discussed in reference to existing neuropsychological literature regarding the consequences of thalamic infarction. It is proposed that damage to the anterior thalamic nuclei results in a frontal dysexecutive syndrome and that such a dysexecutive syndrome can explain the neuropsychological deficits observed in this case.     

Obstructive sleep apnea and depression

Is there an association between obstructive sleep apnea (OSA) and depression? OSA is a common breathing-related sleep disorder. There have been reports that depressive symptoms can be associated with this sleep disorder. A number of investigations have addressed this issue. Although some have found no correlation, most studies have concluded that there is an association between OSA and depressive symptoms. Other investigations have shown that depressive symptoms improve with treatment of OSA, and that untreated OSA may contribute to treatment resistance in some cases of mood disorders. Within the framework of current psychiatric diagnostic criteria, the depressive symptoms associated with OSA can be viewed as a combination of a mood disorder secondary to a primary medical condition and an adjustment disorder with depressed mood. The question of whether OSA causes depressive symptoms can perhaps be best answered by viewing OSA and depression as having certain symptoms that are common to both disorders.     

The relationship between sleep and working memory in children with neurological conditions

The objective of this study is to investigate whether sleep problems might account for the increased working memory deficits observed in school-aged children with neurological conditions. A novel, transdiagnostic approach to the investigation was chosen, and sleep is treated as a process that can potentially account for working memory difficulties across a range of neurological conditions. Prevalence estimates of sleep problems are also examined. Archival data of 237 children aged 6 to 11 years were collected from a Western Australian statewide neuropsychological service for the period 26 July 2011 to 14 January 2014. Measures of parent-reported sleep quality, snoring, and daytime sleepiness were obtained, in addition to objective measures of verbal and spatial working memory, storage capacity, and processing speed. The results of the data analysis reveal that over one third of participants reported having clinically-significant levels of sleep problems and that poor sleep quality is significantly associated with verbal working memory difficulties. This association remains after partialling out the variance contributed to performance by storage capacity and processing speed, suggesting that sleep is impacting upon an executive component of working memory. No other significant associations are observed. The results suggest that poor sleep quality is associated with an executive component of verbal (rather than spatial) working memory in children with neurological conditions. This has implications for the biological mechanisms thought to underlie the relationship between sleep and cognition in children. The results also demonstrate the clinical utility of a transdiagnostic approach when investigating sleep and cognition in children with neurological conditions.     

Specifying the Neuropsychology of Affective Disorders: Clinical,Demographic and Neurobiological Factors

Neuropsychological research in patients with affective disorders shows heterogeneous results with regard to the severity and profile of cognitive impairments. In this paper we hypothesize that the investigation of clinical (subtypes, comorbidity, traumatization, personality, severity, diurnal swings, course, duration, age of onset, biased processing, rumination, motivation, experience of failure, sleep, suicidal tendencies, computer attitudes), demographic (age, education, gender) and neurobiological factors (structural and functional brain changes, glucocorticoids, medication, ECT) that are related to cognitive performance has specified the understanding of severity and profile of neuropsychological impairments. We reviewed the literature pertaining to clinical, demographic and neurobiological factors following Pubmed and PsychInfo databases using different combinations of general key-terms including “Affective Disorder,” “Depression,” “Mania,” “Neuropsychological,” “Neurobiological,” “Moderator,” and “Review” as well as more specific demographic, clinical and neurobiological search terms. Findings from the literature show that the consideration of these factors has improved knowledge about the severity of neuropsychological impairments in patients with affective disorders whereas the neuropsychological profile is still poorly understood. Despite limited understanding, however, the existent results provide promising suggestions for the development of treatment programs.     

Cognitive structure of writing disorders in Russian: what would Luria say?

Acquired disorders of writing in the Russian language have been reported for more than a century. The study of these disorders reflects the history of Russian neuropsychology and is dominated by the syndrome approach most notably by the writings of Luria. Indeed, our understanding of acquired dysgraphia in Russian speakers is conceptualized according to the classical approach in Modern Russia. In this review, we describe the classical approach and compare it to the cognitive neuropsychological models of writing disorders that are developed to explain dysgraphia in English and in other Western European languages. We argue that the basic theoretical assumptions of the two approaches - cognitive and classical or syndrome approach - share similarities. It is therefore proposed that identification of acquired cases of dysgraphia in Russian could potentially benefit from taking the cognitive neuropsychological perspective. We also conclude that adopting elements of the syndrome approach would substantially enrich the understanding of acquired dysgraphia since these offer an insight into processes not described in the cognitive neuropsychological approach.