Cognitive dysfunction in sleep disorders

Fifty-six studies were reviewed that explored cognitive dysfunctions in people with sleep-related breathing disorders (SRBD, 24 studies), insomnia (18 studies), or narcolepsy (14 studies). Individual study outcomes were grouped according to neuropsychological functions. Available evidence was reviewed separately for SRBD, insomnia and narcolepsy. Consistent evidence was found for impaired driving simulation performance in SRBD patients (92.9% of comparisons with control subjects). Other neuropsychological functions with less pronounced impairment included (i) attention span, divided attention and sustained attention for SRBD patients; (ii) attention span, verbal immediate memory and vigilance for insomniac patients, and (iii) sustained attention, vigilance and driving simulation performance for narcoleptic patients. Reduced performance in tasks measuring attention was found to be higher for SRBD and narcoleptic patients (35.9% and 44.2% of all comparisons, respectively) while this rate was lower for insomniac patients (22.8%). Impairment of memory performance in comparison with control subjects was less pronounced for all three groups, with 20.0% for insomnia, 17.1% for SRBD and 15.6% for narcolepsy. In other areas of cognitive functioning, the data did not allow definite conclusions for any of the patient groups. (C) 2001 Harcourt Publishers Ltd.