Application of Cognitive-behavioral Therapy in Obstructive Sleep Apnea: Comparison of CPAP Therapy and CBT on the Executive Functions of the Brain

Abstract

Purpose: Sleep apnea disorder brings about negative effects to the quality of life of the people involved. Debilitation of cognitive functioning is one of the consequences of this condition. Scant researches have been carried out to explore the efficacy of cognitive therapy on mitigating clinical symptoms and cognitive functions of the brain. The novelty of the present study is in combining cognitive method and medical treatment. This research aims to compare the effectiveness of continuous positive air pressure (CPAP) therapy and cognitive-behavioral treatment (CBT) on improving mental cognitive functions in patients with sleep apnea. Methods: The study population included all patients referred to the Bahar Sleep Disorders Clinic in Tehran, Iran. The sample consisted of 45 people who were randomly placed into three groups of 15 people (CPAP therapy, cognitive behavioral therapy, and control groups). All three groups were psychologically assessed prior to the intervention. Next, individuals in the cognitive-behavioral group underwent 12 sessions of cognitive training, progressive muscle relaxation, mental visualization, and sleep hygiene. The other group went through CPAP therapy. After the intervention, both groups were assessed psychologically. Data collection instruments included Wisconsin cognitive software, simple Stroop, complex Stroop, continuous performance, polysomnography device, and CPAP devices. Results: The results indicated that both types of intervention can enhance cognitive functioning; however, a greater efficacy is obtained by combining the two methods compared with the exclusive application of medical treatment. Conclusion: The authors propose cognitive-behavioral therapy OSA as a complement to medical treatment.