Obstructive Sleep Apnea Syndrome (OSAS) is a sleep related breathing disorder with high
epidemiological impact (9-38% of general population), more frequently reported in male
gender and increasing with the age. Pathognomonic OSAS symptoms are snoring, excessive
daytime sleepiness, sleep fragmentation, awakening during the night often for nocturia
and morning headache. The repeated sleep fragmentation due to numerous awakenings (the
patient is often unaware of this) can impair higher cognitive functions over the time and
negatively impact the quality of life, If timely untreated.
Among the most frequently impaired cognitive functions detected in OSAS patients, there
are attention, concentration, amnestic and executive domains. While these impairments are
well documented in literature, the pathogenetic mechanisms underlying cognitive
impairment are not yet defined. To date, the most widely accepted pathophysiological
hypotheses are two: i) intermittent hypoxia (frequent brain awakenings); ii) sleep
fragmentation. Moreover solid evidence report that, there is a strict correlation between
OSAS and neurodegenerative diseases, such as Mild Cognitive Impairment (MCI) and
Alzheimer's Dementia (AD). Indeed, OSAS might act as a trigger, accelerating the
accumulation of harmful proteins in the brain, in particular beta-amyloid and tau
protein.
The first-line treatment for OSAS is Continuous Positive Airway Pressure (CPAP). Of note
is the effect of CPAP treatment on higher cognitive function in OSAS patients.
Not all OSAS' patients, however, develop MCI/AD over time. For this reason, to identify
the OSA phenotype (both clinical and neuroimaging) at higher risk of phenoconversion
represents an important challenge for neuropsychologists and neurologists.
The interest on OSAS is not purely scientific, but also economic, whit important
repercussions on the intake and costs of hospital and home management of OSAS' patients.
In conclusion, OSAS is a syndrome needing great attention for several reasons: i) from a
scientific point of view, it is important to identify for the risk of phenoconversion to
highly disabling neurodegenerative diseases; ii) from an economic-welfare point of view,
to reduce costs that still burden NHS.
In summary, the study may have an important impact on Public Health, considering the
various aspects related to the taking care and management of OSAS' patients: 1) To know
in details, the syndrome epidemiology and on this basis provide for the corresponding
commitment of resources, suitable for implementing the support activities for both
patients and families; 2) To have major information on the real prevalence of clinical
signs and symptoms, to support and optimize the care efforts of physicians; 3) To assess
the prognostic factors and outcomes of the treatment; 4) On the basis of the data
collected in the platform, to have the possibility for support research.
OSAS-platform could represent one of the most effective methods to improve scientific,
clinical and therapeutical knowledge on OSAS-pathology.