Dados do Trabalho

Título

EFFECT OF TREATMENT OF OBSTRUCTIVE SLEEP APNEA WITH CPAP ON AUDITORY EVOKED POTENTIALS

Introdução

The Long Latency Auditory Evoked Potential (LLAEP) makes it possible to objectively assess the functionality and integrity of the auditory pathways by recording the bioelectrical activity of neurons in the thalamocortical regions triggered by a standardized acoustic stimulus. The evoked potential evaluates auditory abilities, such as detection and discrimination, by analyzing the exogenous components P1, N1, P2 and N2. On the other hand, analysis of the endogenous P3 component assesses cognitive abilities such as attention and auditory memory. Previous studies have found alterations in LLAEP components in patients with Obstructive Sleep Apnea (OSA), since the responses depend on the state of attention and degree of sleepiness to the acoustic stimulus. Furthermore, the intermittent hypoxia triggered by OSA can affect neuronal integrity. Despite this evidence, the effects of treating OSA with CPAP remain poorly studied.

Objetivo

The aim of this study was to evaluate the effect of treating moderate to severe OSA with CPAP over 6 months on LLAEP.

Métodos

Adults with OSA participated in the study (09 men and 9 women, age= 57.11± 8.50 years, body mass index= 32.75 ± 6.31 kg/m2, apnea-hypopnea index= 39.14± 74.10 event). The patients were divided into those who adhered to CPAP (study group-GE) or those who did not start using CPAP (control group-GC). All patients were assessed using LLAEP with tone burst stimulation immediately after CPAP treatment was indicated, and 3 and 6 months after the initial assessment.

Resultados

31 adults were studied, 18 from the SG (average of 6.3 hours of CPAP use/night) and 13 from the CG. A high percentage of altered results was observed, especially for the P2 and N2 components, with 22.22%, 22.22%, and 38.89%, 33.33% and 27.78% of altered tests for the P1, N1, P2, N2 and P3 components respectively, with no difference between the groups at any point in the evaluation. In the quantitative analysis, there was a reduction in the latency of the P2 component after three months of using CPAP, but this improvement was not maintained in the 6-month evaluation.

Conclusões

The results of this study suggest that OSA is associated with alterations in the auditory pathways, but treatment of OSA with CPAP does not improve electrophysiological responses, which may be irreversible.

Palavras -chave

Obstructive sleep apnea. Continuous Positive Airway Pressure. Auditory Evoked Potentials. Sleep Questionnaires