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Investigating the effects of CPAP/BiPAP therapy on cognitive function and reaction time in patients with obesity
Shu-Chin Kung1, Yu-Chih Shen2, Hsiu-Mei Wang3
1Department of Human Development and Psychology, Tzu Chi University, Hualien, Taiwan.
Background:
Obesity hypoventilation syndrome (OHS) causes significant neurocognitive dysfunction through chronic hypercapnia and sleep disruption. While continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) effectively treat respiratory symptoms, their comparative effects on cognitive function remain unclear.
Methods:
We conducted a prospective, randomized study of 24 OHS patients examining cognitive function before and after 2 months of positive airway pressure therapy. Eligible patients were randomly allocated to CPAP or BiPAP therapy in a 1:1 ratio; patients who declined treatment formed a non-randomized control group. Primary outcomes were Stroop task accuracy and PSQI score change from baseline. Comprehensive neuropsychological testing included psychomotor vigilance, flanker, and Stroop tasks. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Objective compliance monitoring was performed using device-recorded data.
Results:
Executive function improved significantly in both treatment groups, with Stroop task accuracy increasing > 20% (p < 0.005) and error rates decreasing correspondingly. Sleep quality improved substantially (CPAP: PSQI decreased 6.63 points, p < 0.05; BiPAP: 5.08 points, p < 0.05). BiPAP demonstrated superior benefits for logical memory compared to CPAP (p < 0.05), while psychomotor vigilance and flanker task performance showed no significant changes in either group.
Conclusions:
Both CPAP and BiPAP significantly improve executive function and sleep quality in OHS patients, with BiPAP providing additional memory benefits. These preliminary findings suggest that treatment selection should consider potential cognitive outcomes alongside respiratory parameters. Given the small sample size, results should be interpreted as hypothesis-generating.
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