Aprosexia: symptoms and causes of difficulty in maintaining attention
The relationship between sleep disorders and attention deficits has long been studied by medicine. One of the first concepts used to refer to this relationship is "aprosexia", which is used specifically to relate nasal obstructions to sleep disorders, and from there, with cognitive difficulties during wakefulness.
Next we will see what aprosexia is , where it comes from and how this concept has evolved up to the present.
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What is aprosexia?
The term "aprosexia" is composed of the prefix "a" that indicates "lack of", and the composition element "prosexia" that can be translated as "attention". In this sense, aprosexia refers to lack or inability to pay attention .
It is a term that became popular in the late nineteenth century, when a doctor surnamed Guye, attached to the University of Amsterdam, made a paper entitled "On the aprosexia: the inability to pay attention, and other problems of the functions of the brain, caused by nasal disorders. "
A century before Guye, doctors like John Jacob Wepfer, had described the intense headaches, tremors and memory deficits in relation to nasal obstructions. Likewise, in 1882, a doctor named Hack, suggested that nasal conditions could be studied from a psychiatric point of view.
But it was finally Huye, in 1889, who introduced the term "aprosexia" to refer specifically to memory deficits and the inability to concentrate for long periods ; whose main cause was a nasal obstruction. He studied this mainly in children and young students.
In the same year, William Hill had also concluded that difficulty in breathing was the underlying problem in the development of some children's intellectual disability. For Guye, the aprosexia had a physiological character, since it was a brain fatigue in turn caused by nasal disorders .
But, for Hill, it was not in itself the nasal obstruction that had as a consequence the difficulty to pay attention. It was rather that the nasal obstruction caused the children not to sleep well, and for this reason they did not perform with sufficient alertness and energy during the day.
Both Hill and Guye argued that medically treating nasal obstructions, through surgeries or other medical treatments, could be an effective remedy for inattention. They also maintained that it was necessary to make accurate diagnoses about cases in which a difficulty in breathing at night was causing difficulties to perform different intellectual abilities.
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Nasal obstruction and sleep disorders
After Guye, in 1892, another doctor named Carpenter related sleeping disorders with nasal obstructions. For example, hypertrophic rhinitis was related to insomnia and nightmares, and therefore, with difficulties in paying attention and retaining information in wakefulness . Another doctor, William Fleiss, described 130 cases of this type, and called them "nasal neuroses". Its main symptoms were insomnia and nightmares.
It was finally Wells who in 1898 described 10 cases of people suffering from nasal obstruction, and who reported daytime drowsiness. After restoring their breathing, in a few weeks these people They recovered from symptoms such as insomnia, drowsiness and reduced listening ability .
In conclusion, these studies showed that nasal breathing plays an important role in the maintenance of automatic rhythms of sleep , which in turn, is relevant to keep us sufficiently alert during the day.
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Sleep apnea syndrome and attention deficit
What was previously known as aprosexia, is currently called Sleep-Related Respiratory Disorders (TRAS) and covers the following clinical conditions:
- Obstructive hypopnea .
- Increased resistance in the airways.
- Obstructive sleep apnea syndrome (OSAS) .
The latter may manifest as a complete obstruction or as a partial obstruction with hypoventilation. Among the main causes of mechanical obstruction is a hyperplasia (enlargement of an organ) of the tonsils and adenoids.
Recent studies have shown that there is a comorbidity between attention deficit and respiratory problems during sleep, especially caused by OSAS (Torres Molina and Prego Beltrán, 2013). That is to say, nasal obstructions can dramatically affect breathing during sleep . In turn, an impairment of sleep has as a consequence the decrease in alertness during wakefulness.
For the same reason, one of the elements to take into consideration in order to determine or rule out a diagnosis of attention deficit, is to corroborate if there are respiratory disorders associated with sleep, since the approach in case they do exist may be different .
Bibliographic references:
- Guye, Dr. (1889). On aprosexia, being the inability to fix the attention and other problems in the cerebral functions caused by nasal disorders. The British Medical Journal, pp. 709-710.
- Hill, W. (1889). On some causes of backwardness and stupidity in children: and the relief of these symptoms in some instances by naso-pharyngeal scarifications. The British Medical Journal, pp. 711
- Laive, P. (1983). Nasal Obstructions, Sleep and Mental Function. Sleep, 6 (3): 244-246.
- Torres Molina, A. and Prego Beltrán, C. (2013). Disorders of attention deficit and obstructive sleep apnea syndrome in the pediatric age. Medisur, 11 (1): 61-68.
