Objective: Obstructive sleep apnoea (OSA) is the most common sleep disorder and its prevalence has increased with the obesity pandemic. We aimed to explore the presence of OSA in severe obesity and to evaluate the association of body mass index (BMI) with sleep architecture, cognition, emotional distress and comorbidities in OSA versus non-OSA patients. Methods: A sample of 61 patients performed a neuropsychological battery that included tasks of attention, memory, perceptual/visuospatial ability, vocabulary, inhibition, cognitive flexibility and distress symptomatology, before overnight polysomnography. Results: More than half of the sample had OSA. Excessive daytime sleepiness was not a prominent complaint. Sleep architecture was worse in the OSA than in the non-OSA group, and hypertension was increased with OSA, especially in the severe OSA group. A higher BMI was associated with cognitive distress and sleep variables and with type 2 diabetes. The apnoea-hypopnoea index (AHI) was correlated with gender and cognitive measurements. Cognitive complaints were associated with enhanced distress in both OSA and nonOSA patients. Discussion: OSA is considerably present in severely obese patients. The BMI was strongly associated with other important anthropometric measurements along with worsening sleep architecture and lower executive functioning, both of which may contribute to weight gain. The AHI was significantly higher in men and affected memory and maintaining sets on the Wisconsin Card Sorting Test which may represent a barrier to treatment adherence for this disorder. The substantial presence of cognitive complaints in OSA and non-OSA patients suggests the need for psychological intervention focused on adaptive coping strategies, mostly for depressive symptoms. Given the current obesity epidemic, these results support the need for routine sleep investigation in obese people, particularly in primary care settings. BMI, neuropsychological and emotional screening can provide crucial information about asymptomatic and high-risk patients who require prompt sleep intervention and obesity treatment.

This study aimed to compare the results of a conservative method and the Sleeve Gastrectomy procedure for weight loss on the cognitive-emotional performance of severely obese women assessed for Obstructive Sleep Apnoea Syndrome. Two samples consisting of females, approved for Sleeve Gastrectomy (n = 21) and Conservative Treatment (n = 21) underwent night polysomnography and completed a battery of neuropsychological and emotional tests before and 6 months after the interventions. We compared intra- and inter-sample results, post interventions result to controls, and treated patients with Obstructive Sleep Apnoea Syndrome. Anthropometry, immediate memory, attention, executive functions, and emotional maladjustment improved after the interventions. The conservative method showed better results for inhibitory control, and surgery showed better results for cognitive flexibility, speed of information processing and general cognitive and emotional performance for women with Obstructive Sleep Apnoea Syndrome. Learning decreased following both interventions. Memory and cognitive flexibility were lower in the comparison group than in control groups. Treatments impacted different cognitive domains with probable influence on the objectives achieved. Lower middle pressure for behaviour modification may have reduced learning after interventions. The reduction of depression/anxiety in women with Obstructive Sleep Apnoea may result from the improvement of the social effects of both conditions. Although with better results for the surgical method, anthropometric reductions in both methods, positively influenced the cognitive/emotional domains. The maintenance of cognitive weaknesses implies longer and more focused interventions to avoid the regression of results like the worsening of Obstructive Sleep Apnoea Syndrome.

Aim: The prevalence of obesity has been steadily increasing and is a major worldwide public health problem. It is associated with multiple medical and psychological conditions and recent research supports a link to several cognitive deficit domains, including executive functioning. The aim of this article is to describe socio-demographic, clinical and neuropsychological characteristics of a sample of candidates for bariatric surgery (BS) and to compare their performance with normative values. Method: Between May 2012 and May 2013 we evaluated the neuropsychological performance of 42 patient candidates for BS at the Morbid Obesity Consultation at Centro Hospitalar Lisboa Norte (CHLN). Results: The population was predominantly female and education was equally distributed between basic, secondary and tertiary levels. The neuropsychological results showed a significant decrease on Recall (p < .01), Learning (p < .10), Nonverbal Memory (p < .001), Cognitive Flexibility (p < .01) and Resistance to Interference (p < .05). Conclusion: Despite the limitations inherent to a small sample, the results obtained in the Portuguese population coincide with those of earlier studies; namely that obesity differentially effects instrumental functions.

We examined the presence of the Obstructive Sleep Apnea Syndrome (OSAS) and explored associations/correlations between sleep variables, anthropometric measures, cognitive performance, and psychological distress in severely obese patients. We also sought to verify the relationship between the Cognitive Reserve (CR) and the OSAS.Sixty-one patients who required treatment for severe obesity performed a neuropsychological evaluation and an overnight polysomnography.Most of the patients were female in the age group of 50 years. The incidence of the OSAS defined by Apnea-Hypopnea Index (AHI) was 65.6%. The Severe Apnea group was the biggest, with a statistically significant number of males, significantly higher anthropometric measures, and with a higher percentage of patients with low CR than the other groups. Cognitive performance was significantly affected by sleep parameters, sleep efficiency and REM sleep duration. Great daytime sleepiness and cognitive complaints were correlated with distress symptoms. The female gender, advanced age, the highest weight, daytime sleepiness, hypertension, and oxygen saturation significantly contributed to the onset of the OSAS.The incidence of the OSAS is higher in severely obese patients. Anthropometric measures, cognitive performance, and psychological distress symptoms are influenced by sleep parameters and sleep efficiency. There is a high percentage of patients with Severe Apnea and low CR.