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OBSTRUCTIVE SLEEP APNOEA (OSA): PERSONALITY AND PHYSIOLOGICAL CHANGES
Personality changes and memory loss
Memory deterioration and an inability to concentrate are symptomatic of sleep apnoea. The reasons for this are not completely understood but it is suggested that they result from the cumulative damage of perhaps many years of hypoxaemia during sleep. The disturbed sleep patterns of OSA are also likely to result in such impairment, and there is little doubt that both hypoxaemia and sleep fragmentation contribute to the problem of impaired memory and learning ability. As a consequence of the social readjustments that have to be made and the behavioural and personality changes which may arise, these people may be seen in the first instance by psychiatrists for treatment of depressive illness.
Physiological changes
The behavioural changes which become increasingly apparent to spouse and friends are accompanied by potentially serious physiological changes, particularly to the heart and circulatory system. Some of the changes occur rapidly in response to each of the many obstructive events during sleep. Blood pressure, for example, is normally slightly lower at night than during the day, but in OSA blood pressure rises during apnoeic periods. There can also be quite startling changes in heart rate when the hypoxaemia associated with obstruction induces a slower heart rate (bradycardia) followed by an increase (tachycardia) when normal breathing is resumed. Apnoea may also be associated with irregular heart beats or arrhythmias, which are potentially life threatening. Superimposed over the transient yet dramatic changes which occur during sleep are several long term and persistent abnormalities. Blood pressure often remains high and may be the first measurable symptom observed at an initial consultation. Increased blood pressure and other changes to the blood circulatory system also affect the heart which may become enlarged in an effort to overcome the harmful effects of hypoxaemia on the cardiovascular system.
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