Epilepsy is one of the most prevalent chronic neurological diseases, affecting about 70 million people worldwide. Patients with epilepsy often encounter cognitive dysfunction, which is influenced by different factors including age at the onset of e...

Background/Objectives: Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder associated with cognitive decline. Evidence regarding the reversibility of these deficits after continuous positive airway pressure (CPAP) therapy remains inconsistent. Methods: This prospective observational study included 60 adults with newly diagnosed moderate-to-severe OSA (median age 51 years; 80% male), who underwent baseline assessment using P300 event-related potentials and the Montreal Cognitive Assessment (MoCA). After three months of CPAP therapy with confirmed good compliance, both measures were re-evaluated. Results: After three months of CPAP therapy, a statistically significant reduction in P300 latency (p < 0.001) and an increase in amplitude were observed, accompanied by significant improvements in executive function (p < 0.001), attention (p < 0.001), and delayed recall (p < 0.001). Conclusions: CPAP therapy leads to measurable recovery of cognitive function in patients with moderate-to-severe OSA, suggesting partial reversibility of neurocognitive impairment associated with sleep-disordered breathing. These findings highlight the importance of early recognition and treatment of OSA to prevent long-term cognitive decline.

Background and Objectives: This study aimed to investigate the influence of continuous positive airway pressure in patients with obstructive sleep apnoea on hearing and the possibility of recovering cochlear receptor cells. Materials and Methods: Forty-two patients with obstructive sleep apnoea (OSA) were assigned to the study group. Patients underwent pure-tone audiometry and transient-evoked (TEOAE) and distortion-product (DPOAE) otoacoustic emissions before starting continuous positive airway pressure (CPAP) therapy and six months after CPAP therapy. Subjects were further divided into the following two groups: those who adequately used the therapy and those who did not adhere to treatment recommendations. Results: There is no significant difference in hearing thresholds for specific frequencies after six months of CPAP therapy. There is no significant difference in TEOAE and DPOAE SNR values at any frequency after 6 months of CPAP therapy. There is no significant difference in hearing threshold results for specific frequencies as a function of subject co-operation with treatment. After therapy, there is a significant difference in the SNR values in TEOAEs at 2 kHz and 4 kHz in subjects of the OSA target group, depending on co-operation, being higher in co-operative subjects, while there are no significant differences at other frequencies. There is a significant difference in the SNR results in DPOAEs, where they are higher in co-operative subjects at 1000, 6000, 7000 and 8000 Hz. Conclusions: The use of continuous positive airway pressure as a therapy for OSA has no effect on hearing and cochlear receptor cell recovery. Co-operation with CPAP treatment does not affect hearing threshold, but does affect cochlear receptor cell function, which is better at mid and higher frequencies in those who co-operate. These findings underscore the clinical significance of treatment adherence. Consistent adherence is associated with measurable improvements in hearing, particularly at higher frequencies, which cannot typically be evaluated in routine clinical practice using standard pure-tone audiometry. Our results emphasise the importance of promoting compliance with CPAP therapy not only for cardiovascular and neurological protection, but also for maintaining hearing health.

Obstructive sleep apnea (OSA) is a sleep-related breathing disorder characterized by obstructions of the upper airway during sleep, resulting in repetitive breathing pauses accompanied by oxygen desaturation and arousal from sleep. OSA can be succe...

Background and Objectives: Cognitive deficits are common in obstructive sleep apnea (OSA), and both intermittent hypoxemia and cardiovascular comorbidity may contribute to poorer outcomes. Arterial hypertension (HTN) has been suggested as a potential modifier of cognitive function in OSA, but findings remain inconsistent. This study examined whether HTN influences baseline cognition or cognitive improvement after continuous positive airway pressure (CPAP) therapy in moderate-to-severe OSA and identified predictors of poorer post-treatment cognitive status. Materials and Methods: This prospective study involved 71 adults with newly diagnosed moderate-to-severe OSA (AHI ≥ 15). Participants underwent baseline polysomnography, Montreal Cognitive Assessment (MoCA) testing, and P300 assessments. Cognitive impairment was defined as MoCA < 26 and HTN by antihypertensive therapy, documented diagnosis, or repeatedly elevated blood pressure. All participants initiated auto-adjusting CPAP and were reassessed after three months for adherence, residual respiratory indices, MoCA, and P300 parameters. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were used to identify independent predictors of poorer cognitive outcomes. Results: CPAP therapy significantly improved apnea severity, daytime sleepiness, global cognition, and P300 latency, while P300 amplitude did not change significantly. After three months, hypertensive and normotensive patients showed similar MoCA scores, respiratory outcomes, and P300 amplitude; P300 latency remained marginally longer in hypertensive individuals. Across multivariate models, lower mean nocturnal oxygen saturation and reduced CPAP adherence independently predicted poorer cognitive outcome at follow-up. CPAP adherence demonstrated greater discriminative ability than mean nocturnal oxygenation. Conclusions: In adequately treated moderate-to-severe OSA, HTN did not significantly affect baseline cognition or short-term cognitive recovery with CPAP. Although P300 latency remained slightly prolonged in hypertensive individuals, this difference was marginal and not accompanied by cognitive deficits. Nocturnal oxygenation and CPAP adherence emerged as the strongest predictors of post-treatment cognitive status, underscoring the importance of sustained and effective therapy. These findings suggest that effective CPAP adherence and improved nocturnal oxygenation are crucial for cognitive recovery in OSA patients, regardless of hypertensive status.

Introduction: Obstructive sleep apnea (OSA) is a frequently underdiagnosed condition characterized by symptoms such as excessive daytime sleepiness, fatigue, and reduced quality of life (QoL), while continuous positive airway pressure (CPAP) is the gold standard treatment. This study aimed to examine the impact of CPAP therapy on the quality of life of patients with obstructive sleep apnea. Methods: A comparative cross-sectional study was conducted at the University Hospital Centre Osijek in 100 patients with moderate to severe OSA, comparing pre-CPAP and post-CPAP (≥3 months) groups. Data were collected using a structured questionnaire and the SF-36 health-related quality of life instrument. Results: Compared with the pre-CPAP group, patients using CPAP therapy for at least three months demonstrated significantly better physical functioning (P = 0.03), mental health (P = 0.02), vitality (P = 0.05), and fewer limitations due to physical (P = 0.02) and emotional problems (P = 0.03). CPAP users also reported less frequent fatigue (P = 0.02), better mood (P = 0.02), and greater satisfaction with social functioning (P = 0.01). Regular CPAP users demonstrated better physical functioning (P = 0.05) and fewer limitations due to physical (P = 0.02) and emotional problems (P = 0.03) than occasional users. Compared with women, men reported better quality of life both before and after CPAP therapy, including better physical functioning (P = 0.03) and better mental health after therapy (P = 0.04). Conclusion: Patients with OSA receiving CPAP therapy reported significantly better quality of life than those not receiving CPAP therapy, particularly in the domains of physical and mental functioning. Regular CPAP use was associated with better quality of life, especially with improved physical functioning and fewer physical and emotional limitations. Compared with men, women reported poorer quality of life both before and after CPAP therapy, with greater physical and emotional limitations.