Aprosexia: symptoms and causes of difficulty in maintaining attention

The relationship between sleep disturbances and attention deficits has long been studied in medicine. One of the earliest concepts used to refer to this relationship is that of “aprosexuality,” which is used specifically to relate nasal obstructions to sleep disturbances, and hence to cognitive difficulties during waking hours.

Then we will see what aprosexia is, Where it comes from and how this concept has evolved to the present day.

    What is aprosexia?

    The term “aprosexia” consists of the prefix “a” which indicates “lack of”, and the compositional element “prosexia” which can be translated as “attention”. In this sense, aprosexy refers to lack or inability to pay attention.

    It is a term which became popular at the end of the 19th century, when a doctor named Guye, attached to the University of Amsterdam, produced a work entitled “On aprosexia: the incapacity to lend attention, and other brain function problems caused by nasal disorders “.

    A century before Guye, doctors like John Jacob Wepfer had described severe headaches, tremors, and memory deficits related to nasal obstructions. Also in 1882, a physician named Hack suggested that nasal conditions could be studied from a psychiatric perspective.

    But it was finally Fuig, in 1889, who introduced the term “aprosexia” to specifically designate memory deficits and inability to concentrate for long periods of time; the main cause was nasal obstruction. He studied this mainly in children and young students.

    That same year, William Hill 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, because it resulted from brain fatigue in turn caused by nasal problems.

    But for Hill, it wasn’t the nasal obstruction itself that made it difficult to pay attention. Rather, it was that nasal obstruction prevented the children from sleeping well, and for this reason, they did not show up with sufficient alertness and energy during the day.

    Hill and Guye argued that medically treating nasal obstructions, through surgery or other medical treatment, could be an effective remedy for lack of care. They also argued that accurate diagnoses were needed in cases where difficulty breathing at night caused difficulty in exercising different intellectual skills.

      Nasal obstruction and sleep disturbances

      After Guye, in 1892, another physician named Carpenter associated sleep disturbances with nasal obstructions. For example, hypertrophic rhinitis was associated with insomnia and nightmares, and therefore with difficulty paying attention and remembering information in stride. Another doctor, William Fleiss, described 130 such cases, calling them “nasal neuroses”. Her main symptoms were insomnia and nightmares.

      It was finally Wells who in 1898 described 10 cases of people with nasal obstruction, and who reported daytime sleepiness. After restoring their breathing, in a few weeks these people they have recovered from symptoms such as insomnia, drowsiness and reduced listening skills.

      In conclusion, these studies have shown that nasal breathing plays an important role in maintaining automatic sleep patternsThis, in turn, is relevant in keeping us sufficiently alert during the day.

        Sleep apnea syndrome and attention deficit

        Formerly known as aprosexia, it is now called Sleep Associated Respiratory Disorder (AFTER) and covers the following clinical pictures:

        • obstructive hypopnea.
        • Increased resistance of the respiratory tract.
        • Obstructive sleep apnea syndrome (OSAS).

        The latter may manifest as complete obstruction or as partial obstruction with hypoventilation. One of the main causes of mechanical obstruction is hyperplasia (an increase in the size of an organ) of the tonsils and adenoids.

        Recent studies have shown that there is a comorbidity between attention deficit and breathing problems during sleep, notably caused by OSA (Torres Molina and Prego Beltrán, 2013). In other words, nasal obstructions they can drastically affect breathing during sleep. In turn, a sleep disorder results in decreased alertness while awake.

        For the same reason, one of the elements to take into account when determining or ruling out a diagnosis of attention deficit disorder is to corroborate whether there are respiratory disorders associated with sleep, since the approach in the event of problem may be different. .

        Bibliographical references:

        • Guye, Dr. (1889). In aprosexia, it is the inability to focus attention and other related problems in brain function caused by nasal disorders. The British Medical Journal, pages 709-710.
        • Hill, W. (1889). On certain causes of delay and stupidity in children: and the relief of these symptoms in certain cases by nasopharyngeal scarifications. The British Medical Journal, pages 711.
        • Laive, P. (1983). Nasal obstructions, sleep and mental function. Dorm, 6 (3): 244-246.
        • Torres Molina, A. and Prego Beltrán, C. (2013). Attention deficit disorder and obstructive sleep apnea syndrome in pediatric age. Medisur, 11 (1): 61-68.

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