Treatment of Obstructive Sleep Apnea (13)
As there was only one test form for the Rey Complex Figure, practice effects may have accounted for the differences seen on this measure, particularly for nasal CPAP, as treatment and time of measurement were confounded. While there was a marginal effect of treatment on the measure of constructional praxis (Rey copy; (F[3,21] = 2.82, p<0.07), immediate reproduction of the figure showed the effects of treatment (F[3,21] = 12.12, p<0.001). Immediate recall of the complex figure was better for nasal CPAP (p<0.001) and oxygen (p<0.01) when compared to baseline. A similar effect of treatment was seen for delayed memory of the complex figure (F[3,21] = 7.96, p<0.01). Once again, nasal CPAP (p<0.01) and oxygen (p<0.05) led to better recall of the Rey Figure when compared to baseline.
While there was a tendency for all forms of treatment to improve neuropsychologic test performance, the differences were most significant for visual attention. On the other hand, no changes due to treatment were seen for patients’ subjective ratings of mood.
We were unable to identify characteristics of patients which would predict a more beneficial response to oxygen than to CPAP or vice versa, despite dividing patients into groups of obese vs nonobese, short MSLT (<10 min) vs long MSLT, or low (<90 percent) Sa02 vs high SaO£. buy antibiotics online
No patient lost more than 5 percent of his initial body weight during the three-month course of the study.
All eight subjects have been contacted in follow-up. Range of time since entry in the study has varied from two years to six months. Of the eight subjects enrolled in the study, three (No. 5, 6, and 8) are still using CPAP. Two subjects (No. 1 and 7) are using oxygen. One subject (No. 4) has had a uvulopalatopharyngo-plasty. Follow-up polysomnography indicates that he still has a significant number of apneas, but oxygen desaturation and sleep quality are much improved. One patient (No. 3) refuses any of the tested forms of treatment and is being treated with protriptyline and aminophylline; his attempts to lose weight continue. Patient No. 2 has been lost to follow-up, but is known to be alive.