Abstract：
Undertreated medical illnesses can compound the disabling cognitive deficits of schizophrenia. Obstructive sleep apnea (OSA) impairs cognitive domains also affected by schizophrenia, is common, and is treatable. The effects of sleep apnea on cognition in schizophrenia, however, are not well understood. We estimated the prevalence of OSA in a previously characterized sample of 3942 Veterans with schizophrenia by self-report and with a predictive model to identify individuals at high risk for OSA. We then compared neuropsychological and functional capacity assessment results between those who reported OSA versus those who did not, and between those predicted to have OSA versus predicted to not have OSA. We expected that many Veterans not reporting sleep apnea would be predicted to have it, and that both reported and predicted sleep apnea would be associated with lower cognitive and functional performance. The reported prevalence of OSA in the sample was 14%, whereas 72% were predicted to be at high risk of OSA. Interestingly, participants who reported having OSA had better cognitive and functional capacity performance (p\'s < 0.001) compared to those who did not report OSA, particularly on speed of processing assessments (p < 0.001). Predicted OSA, by contrast, was associated with lower speed of processing, verbal learning and working memory test scores (p\'s < 0.001). One possible interpretation of these results is that people with higher cognitive capacity may be more likely to seek medical care, while those with cognitive impairments are at greater risk for having untreated co-occurring medical conditions that further compromise cognition.
摘要：
治疗不足的医学疾病会加重精神分裂症的致残性认知缺陷。阻塞性睡眠呼吸暂停（OSA）损害认知领域也受精神分裂症的影响，是常见的，是可以治疗的。睡眠呼吸暂停对精神分裂症患者认知功能的影响,然而,不是很了解。我们通过自我报告和预测模型来评估先前特征化的3942名精神分裂症退伍军人样本中OSA的患病率，以确定OSA高危人群。然后，我们比较了报告OSA的人与未报告OSA的人之间的神经心理学和功能能力评估结果，以及预测患有OSA的人与预测没有OSA的人之间的差异。我们预计许多没有报告睡眠呼吸暂停的退伍军人会被预测患有这种疾病，报告和预测的睡眠呼吸暂停与较低的认知和功能表现有关。样本中OSA的报告患病率为14%，而72%被预测为OSA的高风险。有趣的是,与未报告OSA的参与者相比，报告患有OSA的参与者具有更好的认知和功能表现（p<0.001），特别是处理评估的速度(p<0.001)。预测的OSA,相比之下,与较低的处理速度有关，口头学习和工作记忆测试成绩(p<0.001)。对这些结果的一种可能的解释是，认知能力较高的人可能更有可能寻求医疗护理，而那些有认知障碍的人患未经治疗的同时发生的疾病的风险更大，这些疾病会进一步损害认知能力。
