Abstract
Study aimSevere obstructive sleep apnoea (OSA) can lead to neurocognitive alterations, including gait impairments. The beneficial effects of continuous positive airway pressure (CPAP) on improving excessive daytime sleepiness and daily functioning have been documented. However, a demonstration of CPAP treatment efficacy on gait control is still lacking. This study aims to test the hypothesis that CPAP improves gait control in severe OSA patients.Material and methodsIn this prospective controlled study, twelve severe OSA patients (age = 57.2±8.9 years, body mass index = 27.4±3.1 kg·m-2, apnoea-hypopnoea index = 46.3±11.7 events·h-1) and 10 healthy matched subjects were included. Overground gait parameters were recorded at spontaneous speed and stride time variability, a clinical marker of gait control, was calculated. To assess the role of executive functions in gait and postural control, a dual-task paradigm was applied using a Stroop test as secondary cognitive task. All assessments were performed before and after 8 weeks of CPAP treatment.ResultsBefore CPAP treatment, OSA patients had significantly larger stride time variability (3.1±1.1% vs 2.1±0.5%) and lower cognitive performances under dual task compared to controls. After CPAP treatment, stride time variability was significantly improved and no longer different compared to controls. Cognitive performance under dual task also improved after CPAP treatment.ConclusionEight weeks of CPAP treatment improves gait control of severe OSA patients, suggesting morphological and functional cerebral improvements. Our data provide a rationale for further mechanistic studies and the use of gait as a biomarker of OSA brain consequences.
Highlights
Obstructive sleep apnoea (OSA) is a highly prevalent, chronic disease, which is widely accepted as a growing health concern [1]
Before continuous positive airway pressure (CPAP) treatment, OSA patients had significantly larger stride time variability (3.1±1.1% vs 2.1±0.5%) and lower cognitive performances under dual task compared to controls
After CPAP treatment, stride time variability was significantly improved and no longer different compared to controls
Summary
Obstructive sleep apnoea (OSA) is a highly prevalent, chronic disease, which is widely accepted as a growing health concern [1]. The beneficial effects of continuous positive airway pressure (CPAP, the gold standard treatment for OSA) on improving excessive daytime sleepiness and daily functioning have been documented [10]. Greater STV reflects worse gait control and is related to disease severity in disabling neurological conditions [14,15,16]. Two recent studies reported gait impairments in severe OSA. Celle et al [17], in a cross-sectional study showed an association between moderate-to-severe OSA and greater (i.e., worse) STV. Allali et al [18] in a prospective open-labelled study conducted in severe OSA participants reported that gait speed, step and stance time improved after 8 weeks of CPAP treatment, especially when gait was assessed while performing concurrently a cognitively demanding task. Evaluating the effect of CPAP on gait control is required and should demonstrate the relationship between OSA and gait control
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
