Table 5.1.7Neurocognitive and psychological tests in randomized controlled trials of CPAP vs. control

Study
PMID
Baseline Test (SD)Duration(design)InterventionsNo. AnalyzedOutcomeFavorsNet DifferenceIf Significant DifferenceP BtwStudy Quality
95% CITest Range
“Worst”“Best”
Monasterio 2001127
11587974
AHI 21 (5)6 mo (PL)CPAP + CM66Attention - digit symbol (WAIS) SS0NSC
ESS 13.2 (4.3)CM59Attention - digits forward and backward (WAIS) SS0NS
Attention - mental control (WMS) p0NS
Memory - verbal paired associated(WMS) p0NS
Memory - visual memory (WMS), SS0NS
Executive function - Verbal fluency, p0NS
Executive function - Block Design (WAIS), SS0NS
Trailmaking A (sec)0NS
Trailmaking B (sec)0NS
PASAT 4-s,0NS
PASAT 3-s0NS
PASAT 2-s0NS
PASAT 1-s0NS
Vigilance -Steer-clear, % hits0NS
Lojander 1996, 1999125,124
8681614, 10188139
nd12 mo (PL)CPAP + CM23Wechsler Verbal0NSC
CM21Wechsler Performance0NS
Wechsler Memory0NS
Barnes 2004140
15201136
AHI 21 (12) ESS 10.7 (3.5)3 mo (XO)CPAP

Placebo
80Beck Depression Inventory0NSB
Engleman 1999137
9927358
AHI 10 (nd)4 wk (XO)CPAP34SteerClear0NSB
ESS 13 (3)PlaceboTrailmaking A and B0NS
Digit symbolCPAP0.5 *nd0.004
Block Design score0NS
Performance IQ score0NS
HADS anxiety score0NS
HADS depression scoreCPAP0.41 0210.003
PASAT 2-sCPAP0.36 0.02
Barnes 2002131
11897643
AHI 13 (6) [>5]8 wk (XO)CPAP28Word pair memory recall0NSB
ESS 11.3 (5.0)PlaceboWMS-R visual reproduction0NS
Trailmaking A (sec)0NS
Trailmaking B (sec)0NS
Digital symbol substitution test0NS
Controlled oral word association testCPAP+2.70.43, 4.97 §0.02
Psychomotor vigilance task0NS
Stroop color association test0NS
POMS0NS
Mood-Beck depression inventory0NS
Engleman 1998136
9708223
AHI 43 (nd)4 wk (XO)CPAP23SteerClear0NSB
ESS 12.0 (nd)PlaceboTrailmaking B0NS
Digit symbol substitution0NS
Block Design0NS
Performance IQ decrement0NS
HADS anxiety score0NS
Rapid visual information processing0NS
HADS depression score0NS
PASAT 2-s0NS
Engleman 1994133
7906330
AHI 28 (7–129)1 mo (XO)CPAP32IQ decrement scoreCPAP−3.2−6.3, −0.1 **NANA0.04C
ESS ndPlaceboTrailmaking B (sec)CPAP−9−16.5, −1.4 ††NANA0.02
PASAT0NS
HADS anxiety scoreCPAP−1.2−2.2, −0.20210.02
HADS depression scoreCPAP−1.9−3.1, −0.7 ‡‡0210.002
Engleman 1997135
9059469
AHI 11 (4)4 wk (XO)CPAP16IQ decrement score0NSC
ESS ndPlaceboTrailmaking B (sec)CPAP−13.6−25.1, −2.1NANA0.02
PASAT0NS
Verbal fluency total words0NS
HADS anxiety score0NS
HADS depression scoreCPAP−1.6−3.0, −0.20210.03
*

Reported Effect size (final difference/standard deviation of difference)

Reported Effect size (final difference/standard deviation of difference)

Reported Effect size (final difference/standard deviation of difference)

§

Estimated from reported P value.

**

Estimated from reported P value.

††

Estimated from reported P value.

‡‡

Estimated from reported P value.

From: Appendix D, Summary Tables

Cover of Diagnosis and Treatment of Obstructive Sleep Apnea in Adults
Diagnosis and Treatment of Obstructive Sleep Apnea in Adults [Internet].
Comparative Effectiveness Reviews, No. 32.
Balk EM, Moorthy D, Obadan NO, et al.

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