바로가기메뉴

본문 바로가기 주메뉴 바로가기

ACOMS+ 및 학술지 리포지터리 설명회

  • 한국과학기술정보연구원(KISTI) 서울분원 대회의실(별관 3층)
  • 2024년 07월 03일(수) 13:30
 

logo

폐쇄성 수면무호흡증 환자의 주의력 결함 및 수면다원검사 특징

Attention Deficits and Characteristics of Polysomnograms in Patients with Obstructive Sleep Apnea

한국심리학회지: 건강 / The Korean Journal of Health Psychology, (P)1229-070X; (E)2713-9581
2011, v.16 no.3, pp.557-575
https://doi.org/10.17315/kjhp.2011.16.3.008
이유경 (경북대학교)
장문선 (경북대학교)
이호원 (경북대학교)
곽호완 (경북대학교)
  • 다운로드 수
  • 조회수

초록

본 연구에서는 폐쇄성 수면 무호흡증 환자(obstructive sleep Apnea, OSA)의 연령수준에 따른 주의력 결함 특성을 알아보고, 이들의 주의력 결함이 어떤 수면다원검사 지표들과 관련이 있는지 검토하고자 하였다. 두 하위 연령집단 및 정상군에 대해 전산화 주의력측정검사인 연속수행과제와 변화맹시과제를 실시하였다. 추가적으로 수면다원검사의 하위 지표들을 추출하고 주관적 주간졸음을 측정하는 엡워스 주간 졸리움 척도도 실시하였다. 연구결과, OSA군은 정상군과 비교하여 연속수행과제에서 누락 오류와 오경보 오류의 수가 유의하게 많은 것으로 나타났고, 변화맹시 과제에서 정반응률이 유의하게 낮은 것으로 나타났다. 상관분석 결과, OSA군의 주의력 결함은 수면다원검사 지표들 중 저산소혈증과 유의한 상관을 보였다. 결론적으로, OSA군은 부주의하고, 반응억제에 어려움을 보이며, 환경적 자극들 사이에서 일어나는 중요한 변화를 탐지하는데 결함이 있는 것으로 나타났다. 이러한 주의력 결함의 정도는 연령이 증가함에 따라 더욱 심화되었다. 특히 주의력 결함과 비가역적 대뇌 손상을 초래하는 저산소혈증과의 관련성은 OSA 환자의 인지기능의 손상을 예방하기 위해 조기치료가 필요함을 시사한다.

keywords
attention deficit, continuous performance test, change-blindness task, polysomnogram, Obstructive Sleep Apnea, attention deficit, continuous performance test, change-blindness task, polysomnogram, Obstructive Sleep Apnea, 주의력 결함, 연속수행과제, 변화맹시과제, 수면다원검사, 폐쇄성 수면 무호흡증

Abstract

This study tried to examine the characteristics of attention deficits in patients with Obstructive Sleep Apenea(OSA) with different age levels, and to examine which indices of polysomnograms might be related to the indices of attention deficits in OSAs. Two age-level groups and a normal control group were subjected to two computerized attention tests, including a continuous performance test(CPT) and a change blindness task(CBT). In addition, the three groups were subjected to a Polysomnography to extract several sub-indicators of polysomnogram, and an Epworth Sleepiness Scale which measures subjective sleepiness. As results, the OSAs showed significantly more omission and commission errors in CPT, and they showed lower accuracy in CBT compared to the normal group. The results of a correlational analysis showed that attention deficits in OSA are significantly correlated with arterial oxygen saturation among sub-indicators of polysomnograms. In conclusion, OSAs seems to be less attentive, having difficulties in response inhibition, and having deficiencies in noticing important environmental changes. Age seems to make these deficiencies even worse. Especially, the relationship between attention deficiency and hypoxia which could cause irreversible cerebrum damage has an implication in cognitive impairment prevention through early treatment.

keywords
attention deficit, continuous performance test, change-blindness task, polysomnogram, Obstructive Sleep Apnea, attention deficit, continuous performance test, change-blindness task, polysomnogram, Obstructive Sleep Apnea, 주의력 결함, 연속수행과제, 변화맹시과제, 수면다원검사, 폐쇄성 수면 무호흡증

참고문헌

1.

도연정 (2007). 불면증과 수면 무호흡 환자의 인지기능 비교. 영남대학교 대학원 석사학위 청구논문.

2.

손영숙 (2000). 지속적 주의의 이해와 응용. 한국심리학회지: 일반, 19(1), 1-28.

3.

신철 (2009). 수면호흡장애의 유병률과 정의. TubercRespir Dis, 66, 1-5.

4.

이영호, 송종용 (1991). BDI, SDS, MMPI-D 척도의 신뢰도 및 타당도에 대한 연구. 한국심리학회지:임상, 10(1), 98-113.

5.

이주영 (2005). 야간 수면다원기록으로 확진 된 폐쇄성수면 무호흡증 환자의 특성비교. 인제대학교대학원 석사학위 청구논문.

6.

장명근 (2004). 비만이 동반된 폐쇄성 수면 무호흡증 환자에 있어서 수술 후에 시행한 체중감량이 환자의 삶의 질에 미치는 영향. Korean J Otolaryngol, 47, 432-436.

7.

Adams, N., Strauss, M., Schluchter, M., & Redline, S. (2001). Relation of measures of sleep-disordered breathing to neuropsychological functioning. Am J Respir Crit Care Med, 163, 1626-1631.

8.

Aloia, M. S., Arendt, J. T., Davis, J. D., Riggs, R. L., & Byrd, D. (2004). Neuropsychological sequela of obstructive sleep apnea-hyponea syndrome: a critical review. Journal of the International Neuropsychological Society, 10, 772-785.

9.

Alxhanatis, M., Zias, N., Deligiorgis, N., Liappas, I., Chroneou, A., Soldatos, C., & Roussos, C. (2008). Comparison of cognitive performance among different age group in patients with obstructive sleep apnea. Sleep Vreath, 12, 17-24.

10.

American Academy of sleep Medicine (2005). The international classification of sleep disorders, Revised: diagnostic and coding manual. Westchester, IL: American Academy of Sleep Medicine.

11.

Ayalon, L., & Ancoil-Israel, S. (2009). Relationship Between Obstructive Sleep Apnea Severity and Brain Activation During a Sustained Attention Task. Sleep, 32(3), 373-381.

12.

Bedard, M. A., Montplaisir, J., Richer, F., Rouleau, I., & Malo, J. (1991). Obstructive sleep apnea syndrome: pathogenesis of neuropsychological deficits. J Clin Exp Neuropsychol, 13, 950-964.

13.

Beebe, D., & Gozal, D. (2002). Obstructive sleep apnea and the prefrontal cortex: towards a comprehensive model linking nocturnal upper airway obstruction to daytime cognitive and behavioral deficits. J Sleep Res, 11, 1-16.

14.

Billiards, S. S., Walker, D. W., Canny, B. J., & Hirst, J. J. (2002). Endotoxin increases sleep and brain allopregnanolone concentrations in newborn lambs. Pediatr Res, 52, 892-899.

15.

Bixler, E. O., Vgontzas, A. N., Ten Have, T., Tyson, K., & Kales, A. (1998). Effects of age on sleep apnea in men:Ⅰ. Prevalence and severity. Am J Respir Crit Care Med, 157, 144-148.

16.

Borak, J., Cieslicki, J., Szelenberger, W., Wilczak-Szadkowska, H., Koziej, M., & Zielinski, J. (1994). Psychopathological characteristics of the consequences of obstructive sleep apnea prior to and three months after CPAP. Psychiatria Polska, 28, 33-34.

17.

Charlson, M. E., Pompei, P., Ales, K. L, & MacKenzie, C. R. (1996). A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis. 40(5), 373-383.

18.

Choi, B. H., Kim, L., & Suh, K. Y. (1996). Neurocognitive function in obstructive sleep apnea. Sleep Medicine and Psychophysiology, 3, 38-46.

19.

Feuerstein, C., Naegele, B., Pepin, J., & Levy, P. (1997). Frontal lobe-related cognitive functions in patients with sleep apnea syndrome before and after treatment. Acta Neurologica Belgica, 97, 96-107.

20.

Findley, L. J., Powers, D. C., Wihoit, S. C., Boyd, D. G., & Suratt, P. M. (1986). Cognitive impairment in patients with obstructive sleep apnea and associated hypoxemia. Chest, 90, 686-690.

21.

Findley, L., Unverzagt, M., Guchu, R., Fabrizio, M., Buckner, J., & Suratt, P. (1995). Vigilance and Automobile Accidents in Patients with Sleep Apnea or Narcolepsy. Chest, 108, 619-624.

22.

Gosselin, N., Mathieu, A., Mazza, S., Petit, D., Malo, J., & Montplaisir, J. (2006). Attentional deficits in patients with obstructive sleep apnea syndrome: An event-related potential study. Clinical Neurophysiology, 117, 2228-2235.

23.

Gennaro, L. D., Ferrara, M., Urbani, L., & Bertini, M. (2000). Oculomotor impairment after 1 night of total sleep deprivation: a dissociation between measures of speed and accuracy. Clinical Neurophysiology, 111, 1771-1778.

24.

Greenberg, G. D., Watson, R K., & Deptula, D. (1987). Neuropsychological dysfunction in sleep apnea. Sleep, 10, 950-964.

25.

Grevits, J., Simons. B., & Wildenbeest, J. (2003). Effect of sleep deprivation on saccades and eyelid blinking. Eur Neurol, 50, 176-180.

26.

Grillberg, C., & Akerstedt, T. (1998). Sleep loss and performance: No "safe" duration of a monotonous task Physiology and behaviour, 64, 599-04.

27.

Netzer, N. C., Stoohs, R. A., Netzer, C. M., Clark, K., & Strohl, K. P. (1990). Using the Berlin Questionnaire To Identify Patients at Risk for the Sleep Apena Syndrome. Annals of Internal Medicine, 131, 486-491.

28.

Johns, M. W. (1991). A new method for measuring daytime sleepiness: The Epworth Sleepiness Scale. Sleep, 14(6), 540-545.

29.

Kelly, D. A., Claypoole, K. H., & Coppel, D. B. (1990). Sleep apnea syndrome: symptomatology, associated features, and neurocognitive correlateds. Neuropsychol Rev, 1, 323-342.

30.

Kighshott, R. N., Cowan, J. O., & Jones, D. R. (2004). The role of sleep-disordered breathing, daytime sleepiness, and impaired performance in motor vehicle crashed a control study. Sleep Breath, 8, 61-72.

31.

Kim, J. K., In, K. H., Kim, J. H., You, S. H., Kang, K. H., Shim, J. J., Lee, S. Y., Lee, J. B., Lee, S. G., Park, C., & Shin, C. (2004). Prevalence of Sleep-Disordered Breathing in Middle-aged Korean Men and Women. Am J Respir Crit Care Med, 170, 1108-1113.

32.

Knight, H., Millman, R. P., Gur, R. C., Saykin, A. J., Doherty, J. U., & Pack, A. I. (1987). Clinical significance of sleep apnea in the elderly. Am Rev Respir Dis, 136, 845-850.

33.

Koslowsky, M., & BabkoV, H. (1992). Meta-analysis of the relationship between total sleep deprivation and performance. Chronobiology International, 9, 132-136.

34.

LeBerge, D. (1995). Attentional processing: the brain's art of mindfulness. Cambridge: Harvard University Press.

35.

Mathieu, A., Mazza, S., Decary, A., Massicotte-Marquez, J., Petit, D., Gosselin, N., Malo, J., & Montplaisir, J. (2008). Effects of obstructive sleep apnea on cognitive function: A comparison between younger and older OSAS patients. Sleep Medicine, 9, 112-120.

36.

Mazza, S., Pepin, J. L., Naegele, B., Plante, J., Deschaux, C., & Levy, P. (2005). Most obstructive sleep apnoea patients exhibit vigiliance and attention deficits on an extended battery of tests. Eur Respir J, 25, 75-80.

37.

Mazza, S., Pepin, J. L., Naegele, B., Rauch, E., Deschaux, C., Ficheux, P., & Levy, P. (2006). Driving ability in sleep apneoea patients before and after CPAP treatment: evaluation on a road safety platform. Eur Respir J, 28, 1020-1028.

38.

Munoz, A., Mayoralas, L. R., Barbe, F., Pericas, J., & Agusti, A. G. (2000). Long-term effects of CPAP on daytime functioning in patients with sleep apnea syndrome. Eur Respir J, 15, 676-681.

39.

Naegele, B., Thouvard, V., Pepin, J. L., Levy, P., Bonnet, C., Perret, J. E.., Pellat, J., & Feuerstein, C. (1995). Deficits of cognitive excutive functions in patients with sleep apnea syndrome. Sleep, 18, 43-52.

40.

Redline, S., Strauss, ME., Adams, N., Winters, M., Roebuck, T., Spry, K., Rosenberg, C., & Adams, K. (1997). Neuropsychological function in mild sleep-disordered breathing. Sleep, 20(2), 160-167.

41.

Rensink, R. A. (2002). When good observers go bad: Change blindness, inattentional blindness, and visual experience. Psyche, 6(9)

42.

Rizzo, M., Sparks, J. D., McEvoy, S., Viamonte, S., Kellison, I., & Vecera, S. P. (2009). Change blindness, aging, and cognition. Journal of Clinical and Experimental Neuropsychology, 31(2), 245-256.

43.

Roehrs, T., Merrion, M., Pedrosi, B., Stepanski, E., Zorick, F., & Roth, T. Neuropsychological function in obstructive sleep apnea syndrome(OSAS) compared to chronic obstructive pulmonary disease(COPD). Sleep, 18, 382-388.

44.

Sassani, A., Findley, L. J., Kryger, M., Goldlust, E., George, C., & Davidson, T. M. (2004). Reducing Motor-Vehicle Collisions, Costs, and Fatalities by Treating Obstructive Sleep Apnea Syndrome. Sleep, 27(3), 453-458.

45.

Simons, D. J., & Rensink, R. A.(2005). Change blindness: Past, present, and future. Trends in Cognitive Sciences, 9, 16-20.

46.

Stenowsky, C. J., & Davidson, T. M. (2004). Nightly variability of sleep-disordered breathing measured over 3 nights. Otolaryngol Head and Neck Surg, 131, 837-843.

47.

Telekavi, T., Kajaste, S., Partinen, M., Koskenvuo, M., Salmi, T., & Kaprio, J. (1988). Cognitive function in middle-aged snorers and control: role of excessive daytime somnolence and sleep-related hypoxic events. Sleep, 454-462.

한국심리학회지: 건강