The psychosocial aspects of obstructive sleep apnea

The primary events of obstructed breathing during sleep, snoring and obstruction of the upper airway, cause hypoxemia, sleep fragmentation, and daytime sleepiness. Obstructed breathing during sleep can have negative effects on mental processes, behavior, and interpersonal relations. This article reviews some of the cognitive, emotional, and social aspects of obstructive sleep apnea in adults and children. Apnea is associated with cognitive impairments but these are generally mild. Most studies suggest that these impairments improve with CPAP but evidence suggests that some changes may be permanent. Even mild apnea may worsen depression and quality of life. Apnea may have more profound effects in children but the findings are inconclusive. This may be due to difficulty in recognizing sleep apnea in children, the subtle nature of the disorder, the lack of daytime sleepiness, and the imposition of adult norms on children's sleep studies.