[Psychophysiological and psychological consequences after surgical treatment of obstructive sleep apnea syndromes]

Abstract

The purpose of this study is to investigate the effects of surgical treatment of psychophysiological and psychological measurement of obstructive sleep apnea syndromes (OSAS) patients, and to clarify the interrelationships regarding an evaluation of its improvement. The subjects, 17 inpatients (mean age: 41.9 +/- 13.8 [17-61] 15 males, 2 females), were given the diagnosis of OSAS at the International Classification of Sleep Disorders. 4-5 days before (Pre-Treatment: PT), 5-22 days after (13.0 +/- 4.8 days, Post-Operation: PO) and 3-6 months after (4.2 +/- 1.0 months, Follow Up: FU) the surgery, the examinations were performed. Polysomnography (PSG) were recorded from 21:00 to 6:00. Following PSG, for the changes in daytime sleepiness, Multiple Sleep Latency Test (MSLT), Stanford Sleepiness Scale (SSS) and Spaceaeromedicine fatigue check list (SAM) were applied with the interval of 2 hours from 8:00 to 20:00. The psychological battery were performed at PT and FU, that consisted of Uchida-Kraepelin Test (U-K), Wechsler Adult Intelligence Scale-Revised (WAIS-R), Benton Visual Retention Test (BVRT) and Minnesota Multiphasic Personality Inventory (MMPI). Surgical procedures were determined by means of radiological and endoscopic examinations. The results were as follows. A. Psychophysiological measurement (1) Apnea Index (AI) decreased at PO compared with PT. Further at FU. AI improved significantly compared with PT and PO [AI: 43.9 +/- 19.2-->20.5 +/- 16.5-->11.2 +/- 11.4]. And apnea duration shortened significantly at PO and FU. In addition, % time O2 saturation below 90% (SaO2 < or = 90%) decreased significantly at FU compared with PT. (2) With the improvement of respiratory disturbance, the sleep architecture of FU improved more than those of PO, such as increase of sleep efficiency, %stage 2 and %stage 3 + 4, decrease of No. of stage shift, %Wake and %stage 1. (3) Daily average of MSLT Scores at PO did not change compared with PT. But at FU, they improved significantly to normal range [6.7 +/- 3.0-->8.0 +/- 3.5-->11.4 +/- 3.9 (min.)], whereas daily average of SSS and SAM improved significantly at both PO and FU compared with PT. B. Psychological measurement (1) Dysfunction of task performance improved at FU. Mean value in U-K (1st and 2nd half) and mean IQ (performance and total) in WAIS-R increased significantly at FU compared with PT. (2) Immediate visual memories in BVRT did not change within normal range. (3) MMPI profiles at PT didn't show any personality or mood characteristics.(ABSTRACT TRUNCATED AT 400 WORDS)