ABSTRACT
This article reviews the effects of obstructive sleep apnea on neurocognitive performance, proposed mechanisms of cognitive impairment, and the effects of continuous positive airway pressure on performance. Obstructive sleep apnea can affect several domains of neurocognitive performance to include attention and vigilance, memory and learning, psychomotor function, emotional regulation, and executive function. Proposed mechanisms include intermittent hypoxemia, sleep deprivation and fragmentation, hypercapnia, and disruption of the hypothalamic-pituitary-adrenal-axis. Continuous positive airway pressure can improve cognitive defects associated with obstructive sleep apnea. More data are needed to determine whether other therapies improve cognitive function.
Subject(s)
Cognition/physiology , Cognitive Dysfunction/psychology , Sleep Apnea, Obstructive/psychology , Sleep Deprivation/psychology , Attention/physiology , Cognitive Dysfunction/etiology , Continuous Positive Airway Pressure , Executive Function/physiology , Humans , Sleep Apnea, Obstructive/therapy , Sleep Deprivation/complicationsABSTRACT
One of the causes of diffuse pulmonary infiltrates can be blood from diffuse alveolar hemorrhage. Other causes include malignancy, edema fluid, infections, and protein (blood, pus, water, cells, or protein). Autoimmune vasculitis, such as Wegener's granulomatosis, should be considered in the setting of diffuse pulmonary infiltrates, anemia, systemic symptoms, and recurrence despite antibiotic therapy. Antineutrophilic cytoplasmic antibody testing can be useful but is not always diagnostic. Early tissue biopsy should be considered to guide therapy. We present a case of Wegener's granulomatosis that presented with diffuse alveolar hemorrhage. Diagnosis was made through renal biopsy; however, antineutrophilic cytoplasmic antibody testing was negative. A brief overview of pulmonary-renal vasculitides is also presented.
