Deficits in involuntary attention switching in obstructive sleep apnea syndrome

Cognitive functions are altered in patients with obstructive sleep apnea syndrome (OSAS) and it has been proposed that vigilance and attentional deficits play a pivotal role in all aspects of these deficits. One way to assess attentional system integrity is the study of event-related-potentials (ERP), but only a few ERP studies have been conducted in patients with OSAS. The aim of the study was to use ERP to further assess attentional impairments in these patients. Thirteen OSAS patients and 13 age-matched controls underwent a night of polysomnographic recording. Each subject was also tested with an ERP paradigm where standard (95%, 1000Hz), high deviant (2.5%, 1250Hz) and low deviant (2.5%, 1050Hz) tones were presented. Subjects were asked to ignore the stimuli and read during the task. Mismatch negativity (MMN) and P3a amplitudes and latencies were measured. No between-group difference was observed for sleep stages, except a lower percentage of rapid eye movement (REM) sleep in patients with OSAS (p<0.01). Moreover, the OSAS group showed a higher micro-arousal index and more sleep transitions than the control group (p<0.05). A significant group effect was found for the amplitude of the P3a component (p<0.05) that was lower in patients with OSAS for both high and low deviant tones. No between-group difference was found for the MMN and the P3a latencies. In conclusion, patients with OSAS have specific alterations of the P3a component that reflects involuntary attention switching, but automatic auditory processing assessed by MMN appears to be preserved.