Aprosexia: Symptoms And Causes Of Difficulty Maintaining Attention
The relationship between sleep disorders and attention deficits has been widely studied by medicine. One of the first concepts that was used to refer to this relationship is that of “aprosexia”, which is specifically used to relate nasal obstructions with 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 to the present day.
The term “aprosexia” is composed of the prefix “a” which indicates “lack of”, and the compositional element “prosexia” which can be translated as “attention”. In this sense, aprosexia refers to the lack or inability to pay attention
It is a term that became popular at the end of the 19th century, when a doctor named Guye, attached to the University of Amsterdam, carried out a work entitled “On aprosexia: the inability to pay attention, and other problems of the functions of the brain, caused by nasal disorders.
A century before Guye, physicians such as John Jacob Wepfer had described severe 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 breathing was the underlying problem in the development of intellectual disability in some children. For Guye, aprosexia had a physiological character, since it resulted from brain fatigue in turn caused by nasal disorders
But, for Hill, it was not the nasal obstruction itself that resulted in difficulty paying attention. It was more that the nasal obstruction caused the children to not sleep well, and for this reason they did not function with sufficient alertness and energy during the day.
Both Hill and Guye argued that medically addressing nasal obstructions, through surgery or other medical treatments, could be an effective remedy for inattention. They also maintained that it was necessary to make accurate diagnoses of cases in which difficulty breathing at night was causing difficulties in performing different intellectual skills.
Nasal obstruction and sleep disorders
After Guye, in 1892, another doctor named Carpenter related sleep disorders to nasal obstructions. For example, hypertrophic rhinitis was related to insomnia and nightmares, and therefore, with difficulties paying attention and retaining information while awake Another physician, William Fleiss, described 130 such cases, calling them “nasal neuroses.” His 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 sleepiness. After restoring their breathing, within a few weeks these people recovered from symptoms such as insomnia, drowsiness and reduced listening ability
In conclusion, these studies showed that nasal breathing plays an important role in maintenance of automatic sleep rhythms which in turn is relevant to keeping us sufficiently alert during the day.
What was previously known as aprosexia is currently called Sleep-Related Breathing Disorders (SRB) and covers the following clinical conditions:
The latter can manifest as complete obstruction or partial obstruction with hypoventilation. Among the main causes of mechanical obstruction is hyperplasia (enlargement of an organ) of the tonsils and adenoids.
Recent studies have proven that there is a comorbidity between attention deficit and breathing problems during sleep, especially caused by OSA (Torres Molina and Prego Beltrán, 2013). This means that nasal obstructions can dramatically affect breathing during sleep In turn, a sleep disorder results in a decreased alertness during wakefulness.
For the same reason, one of the elements to take into consideration when trying to determine or rule out a diagnosis of attention deficit is to corroborate whether there are respiratory disorders associated with sleep, since the approach if they do exist may be different. .
