Neuropsychological and socio–cognitive deficits in patients with obstructive sleep apnea

Macchitella, Luigi; Romano, Daniele; Marinelli, Chiara Valeria; Toraldo, Domenico Maurizio; Arigliani, Michele; Benedetto, Michele De; Angelelli, Paola

doi:10.1080/13803395.2021.1944609

Cited by 13 publications

(5 citation statements)

References 159 publications

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“…Further, in OSA patients, sleep misperception is frequent [13]. Other questionnaires indicate the presence of yet other symptoms, such as fatigue (ie Fatigue Severity Scale) [14,15], depression and cognitive deficits [16,17].…”

Section: Dear Colleaguesmentioning

confidence: 99%

“Sleepiness” in obstructive sleep apnea: getting into deep water

2022

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Section: Dear Colleaguesmentioning

confidence: 99%

“Sleepiness” in obstructive sleep apnea: getting into deep water

2022

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“…Women are more likely to present with atypical symptoms of OSA, even in mild OSA, that is associated with lower levels of apnea–hypopnea index (AHI) scores (hypoxic events per hour of sleeping) than men [ 4 , 5 ]. Symptoms of OSA include cognitive dysfunction, anxiety, and compulsivity [ 6 – 12 ], along with increased inflammation and oxidative stress (OS) [ 13 – 18 ], decreased testosterone in men [ 19 – 21 ], and decreased estradiol and progesterone in women [ 22 – 24 ]. Though women have been observed to have greater risk for OSA-associated cognitive dysfunction [ 3 , 25 ], the role of sex on OSA symptoms is not completely understood.…”

Section: Introductionmentioning

confidence: 99%

Sex-dependent effects of chronic intermittent hypoxia: implication for obstructive sleep apnea

Mabry,

Bradshaw,

Gardner

et al. 2024

Biol Sex Differ

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Background Obstructive sleep apnea (OSA) affects 10–26% of adults in the United States with known sex differences in prevalence and severity. OSA is characterized by elevated inflammation, oxidative stress (OS), and cognitive dysfunction. However, there is a paucity of data regarding the role of sex in the OSA phenotype. Prior findings suggest women exhibit different OSA phenotypes than men, which could result in under-reported OSA prevalence in women. To examine the relationship between OSA and sex, we used chronic intermittent hypoxia (CIH) to model OSA in rats. We hypothesized that CIH would produce sex-dependent phenotypes of inflammation, OS, and cognitive dysfunction, and these sex differences would be dependent on mitochondrial oxidative stress (mtOS). Methods Adult male and female Sprague Dawley rats were exposed to CIH or normoxia for 14 days to examine the impact of sex on CIH-associated circulating inflammation (IL-1β, IL-6, IL-10, TNF-α), circulating steroid hormones, circulating OS, and behavior (recollective and spatial memory; gross and fine motor function; anxiety-like behaviors; and compulsive behaviors). Rats were implanted with osmotic minipumps containing either a mitochondria-targeting antioxidant (MitoTEMPOL) or saline vehicle 1 week prior to CIH initiation to examine how inhibiting mtOS would affect the CIH phenotype. Results Sex-specific differences in CIH-induced inflammation, OS, motor function, and compulsive behavior were observed. In female rats, CIH increased inflammation (plasma IL-6 and IL-6/IL-10 ratio) and impaired fine motor function. Conversely, CIH elevated circulating OS and compulsivity in males. These sex-dependent effects of CIH were blocked by inhibiting mtOS. Interestingly, CIH impaired recollective memory in both sexes but these effects were not mediated by mtOS. No effects of CIH were observed on spatial memory, gross motor function, or anxiety-like behavior, regardless of sex. Conclusions Our results indicate that the impact of CIH is dependent on sex, such as an inflammatory response and OS response in females and males, respectively, that are mediated by mtOS. Interestingly, there was no effect of sex or mtOS in CIH-induced impairment of recollective memory. These results indicate that mtOS is involved in the sex differences observed in CIH, but a different mechanism underlies CIH-induced memory impairments.

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“…Alternatively, airflow must show a reduction at least five times per hour, including a drop in oxygen or a rise in carbon dioxide 22 . The results of disrupted sleep and hypoxia are excessive daytime sleepiness (EDS) 23 , fatigue, depression 24 , and cognitive complaints 25 , 26 . Cognitive domains usually impaired in OSA are working memory, vigilance/attention 27 and executive functioning 19 , 21 , 28 , 29 .…”

Section: Introductionmentioning

confidence: 99%

Treatment of hypertension and obstructive sleep apnea counteracts cognitive decline in common neurocognitive disorders in diagnosis-related patterns

Kujovic,

Lipka,

Zalman

et al. 2023

Sci Rep

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The aim of this study was to investigate the effect of arterial hypertension (AH) and of obstructive sleep apnea (OSA) on cognitive course in the neurocognitive disorder (NCD) cohort RIFADE which enrolled patients with NCD due to Alzheimer’s disease (AD), vascular NCD (vNCD), and mixed NCD (AD + vNCD = mNCD). Multiple risk factors (RF), including AH and OSA, that contribute to the development of various kinds of dementia have been identified in previous studies. Studies that observed AH lacked investigation of long-term effects and did not isolate it from other RF. Studies involving OSA as a risk factor did not include participants with all stages of NCD. 126 subjects were screened for AH and OSA. Repeated cognitive measurements were performed with the DemTect as primary outcome and the clock drawing test as secondary outcome measure. 90 patients had AH (71.4%) and 40 patients had OSA (31.7%). RF-status had a significant effect on cognitive outcome in models with RF as single factors (AH p = 0.027, OSA p < 0.001), a 2-factor analysis with AH × OSA (AH as main factor p = 0.027) as well as a model including the 3 factors AH × OSA × diagnosis (p = 0.038). Similarly, a 3-factor model was significant for the clock-drawing test, whereas single factor-models remained insignificant. AH and OSA appear to be risk factors in common NCD and cognitive decline can be mitigated by treatment of these RF.

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Neuropsychological and socio–cognitive deficits in patients with obstructive sleep apnea

Cited by 13 publications

References 159 publications

“Sleepiness” in obstructive sleep apnea: getting into deep water

“Sleepiness” in obstructive sleep apnea: getting into deep water

Sex-dependent effects of chronic intermittent hypoxia: implication for obstructive sleep apnea

Treatment of hypertension and obstructive sleep apnea counteracts cognitive decline in common neurocognitive disorders in diagnosis-related patterns

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