Cognitive Function in a Sleep Clinic Cohort of Patients with Obstructive Sleep Apnea

Beaudin, Andrew E.; Raneri, Jill K.; Ayas, Najib; Skomro, Robert; Fox, Nurit; Allen, Angier; Bowen, Matthew; Nocon, Andrhea; Lynch, Emma; Wang, Meng; Smith, Eric E.; Hanly, Patrick J.

doi:10.1513/annalsats.202004-313oc

Cited by 40 publications

(26 citation statements)

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“…Overall, associations were found between OSA and decreased attention [5,7,8,30,31], memory [5,26,32], and executive function [7,8], which are generally in line with previous findings. The same can be seen in the results of analyses studying OSA-associated severity markers such as AHI or ODI, where the results often fail to replicate the associations between the cognitive markers and the presence of OSA [5,7,30,31]. Specifically, André et al (2020) found no significant correlations between OSA-associated parameters and cognition (global cognitive function, processing speed, attention, working memory, executive function, and episodic memory) [11].…”

Section: Sleep Apnoea and Cognitionsupporting

confidence: 91%

“…An attempt to resolve this was proposed by D'Rozario et al (2018), who developed a brief 30min assessment which evaluates neurobehavioural function [7]. Overall, associations were found between OSA and decreased attention [5,7,8,30,31], memory [5,26,32], and executive function [7,8], which are generally in line with previous findings. The same can be seen in the results of analyses studying OSA-associated severity markers such as AHI or ODI, where the results often fail to replicate the associations between the cognitive markers and the presence of OSA [5,7,30,31].…”

Section: Sleep Apnoea and Cognitionsupporting

confidence: 59%

“…In this review, we have summarised recent findings on the association between OSA and brain structure, cognition, and the two most common neurodegenerative disorders, namely Alzheimer's dementia and Parkinson's disease. Overall, recent studies reported associations between OSA and grey and white matter alterations [3, 10-12, 20, 22-24], and changes in brain diffusion [13,25,26], as well as impaired cognition, specifically regarding memory [5,6,26,32], attention [5,7,8,30,31], and executive control [7,8]. Furthermore, subjects with OSA were found to have a higher risk of developing mild cognitive impairment (MCI) [5,27], Alzheimer's dementia [16,17,[39][40][41], and Parkinson's disease [47], and show shorter progression times between cognitively normal and MCI or MCI and Alzheimer's dementia [17].…”

Section: Discussionmentioning

confidence: 97%

“…In a meta-analysis based on 19,940 subjects, those with OSA were 2.44 times more likely to develop mild cognitive impairment (MCI), with women being at a higher risk (RR = 2.06) than men (RR = 1.18) [27]. Similarly, Beaudin et al (2020) (N = 1084) found OSA presence and nocturnal hypoxia to be associated with higher cognitive impairment and the presence of moderate-severe OSA with higher odds of having MCI [5]. Interestingly, according to a study performed on 101 subjects by Gagnon et al (2019), subjects with OSA and MCI seem to be less aware of their cognitive deficits than subjects without OSA [28].…”

Section: Sleep Apnoea and Cognitionmentioning

confidence: 96%

“…Alternatively, oral devices or, in extreme cases, surgical procedures are available [2]. A growing body of evidence has shown the impact of OSA on reduced cognition [5][6][7][8][9], brain morphology [3,[10][11][12][13], and neurodegenerative pathophysiology [11,[14][15][16][17][18]. Furthermore, it has been shown that the treatment of OSA mitigates some of its negative consequences [13,16,[19][20][21], suggesting that, with readily available treatment options, OSA is a promising target to delay the onset of neurodegenerative disorders such as dementia, Alzheimer's disease (AD), or Parkinson's disease (PD).…”

Section: Introductionmentioning

confidence: 99%

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The Link Between Obstructive Sleep Apnoea and Neurodegeneration and Cognition

Weihs

Frenzel

Grabe

2021

Curr Sleep Medicine Rep

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Purpose of Review Obstructive sleep apnoea (OSA) is increasingly found to have an impact on neurodegeneration. In this review, we summarise recent findings on the association between OSA and brain morphology, cognition, and processes related to Alzheimer’s dementia (AD) and Parkinson’s disease (PD). Recent Findings Associations between OSA and alterations in grey and white matter, brain diffusivity, and deficits in memory, attention, and executive control were reported. Furthermore, OSA was correlated with higher risks of developing AD and PD and associated pathophysiology. Treatment was found to alleviate but not reverse some of the damage. Summary There are strong indications that OSA plays a major role in neurodegenerative processes. The broad picture however remains elusive, likely due to insufficient sample sizes, heterogeneous outcomes, and OSA definitions failing to quantify the disorder’s sub-processes. While studies resolving these issues are required, the available evidence shows OSA to be a promising target to slow neurodegeneration and delay the onset of related disorders.

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Section: Sleep Apnoea and Cognitionsupporting

confidence: 91%

Section: Sleep Apnoea and Cognitionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 97%

Section: Sleep Apnoea and Cognitionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The Link Between Obstructive Sleep Apnoea and Neurodegeneration and Cognition

Weihs

Frenzel

Grabe

2021

Curr Sleep Medicine Rep

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Respiratory muscle training for obstructive sleep apnoea

Rueda-Etxebarria

Mugueta-Aguinaga

Rueda

et al. 2021

Cochrane Database of Systematic Reviews

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Subjective cognitive complaints and objective cognitive impairment in patients suspected of obstructive sleep apnea who underwent polysomnography

Rattanabannakit,

Kuendee,

Tungwacharapong

et al. 2024

Int J Geriat Psychiatry

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ObjectivesObstructive sleep apnea (OSA) is linked to cognitive impairment. We aimed to investigate subjective cognitive complaints (SCCs) and objective cognitive scores and their relation to polysomnography (PSG) parameters in patients suspected of having OSA.MethodsA prospective cohort cross‐sectional study was conducted at Siriraj Hospital. Patients suspected of OSA who were scheduled for PSG were recruited. Cognition was assessed using the Montreal Cognitive Assessment (MoCA) and Color Trails Test (CTT). The Memory Index Score (MIS) was calculated from the MoCA. Subjective cognitive complaint presence was assessed through direct questioning of patients and by employing the Cognitive Change Index rated by self or informants (CCI‐I). Patients with severe dementia were excluded.ResultsAmong 258 patients (mean age 61.46 ± 7.05 years, 51.2% female), the mean MoCA score was 23.89 ± 3.89. Based on PSG results, patients were categorized into groups as follows: those without OSA or with mild OSA (combined total of 20.1%), moderate OSA (28.3%), or severe OSA (51.6%). Cognitive Change Index rated by self and CCI‐I scores correlated significantly (r = 0.238, p = 0.019) but not with the MoCA score or CTT time. Objective cognitive scores were associated with PSG parameters: total sleep time (TST), sleep onset latency, wake after sleep onset, sleep stages, mean O2 saturation, and time spent with SaO2 below 90% (all p < 0.05). Subjective cognitive scores were not associated with PSG parameters, except CCI‐I with TST. Participants with objective cognitive impairment had lower education, higher body mass index, more comorbidities, and lower SCC percentage (all p < 0.05). Patients with moderate to severe OSA had a higher proportion of objective cognitive impairment (64.1%) but a lower incidence of SCC (38.3%) than patients with no OSA or mild OSA. Thirty patients with severe OSA and cognitive impairment received continuous positive airway pressure (CPAP) treatment for a mean of 12.2 months. These patients showed MoCA and MIS improvement, but no significant changes were observed in their CTT and Cognitive Change Index scores.ConclusionsMost patients with OSA had objective cognitive impairment, but SCC was less frequent in patients with more severe OSA. Several PSG parameters correlated with cognitive scores but not with subjective cognitive scores. Patients with severe OSA may benefit cognitively from CPAP treatment.

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Cognitive Function in a Sleep Clinic Cohort of Patients with Obstructive Sleep Apnea

Cited by 40 publications

References 50 publications

The Link Between Obstructive Sleep Apnoea and Neurodegeneration and Cognition

The Link Between Obstructive Sleep Apnoea and Neurodegeneration and Cognition

Respiratory muscle training for obstructive sleep apnoea

Subjective cognitive complaints and objective cognitive impairment in patients suspected of obstructive sleep apnea who underwent polysomnography

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