The Link Between Obstructive Sleep Apnoea and Neurodegeneration and Cognition

Weihs, Antoine; Frenzel, Stefan; Grabe, Hans J.

doi:10.1007/s40675-021-00210-5

Cited by 8 publications

(5 citation statements)

References 57 publications

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“…Sleep apnea is strongly associated with cognitive deficits (40,76) with nocturnal hypoxemia closely linked to impaired memory performance (77). While sleep apnea and cognitive decline may co-occur as part of an underlying neurodegenerative illness (78,79), cognitive deficits may also be secondary to or aggravated by sleep apnea (76,80,81). This picture fits with the Cluster 3 we identified, which included people with greater sleep apnea severity and reduced memory performance (although not as severe as Cluster 2).…”

Section: Discussionsupporting

confidence: 68%

Sleep spindle architecture associated with distinct clinical phenotypes in older adults at risk for dementia

Orlando

O’Callaghan

Lam

et al. 2023

Preprint

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Sleep spindles are a hallmark of non-REM sleep and play a fundamental role in memory consolidation. Alterations in these spindles are emerging as sensitive biomarkers for neurodegenerative diseases of ageing. Understanding the clinical presentations associated with spindle alterations may help to elucidate the functional role of these distinct electroencephalographic oscillations and the pathophysiology of sleep and neurodegenerative disorders. Here, we use a data-driven approach to examine the sleep, memory and default mode network connectivity phenotypes associated with sleep spindle architecture in older adults (mean age = 66 years). Participants were recruited from a specialist clinic for early diagnosis and intervention for cognitive decline, with a proportion showing mild cognitive deficits on neuropsychological testing. In a sample of 88 people who underwent memory assessment, overnight polysomnography and resting state fMRI, a k-means cluster analysis was applied to spindle measures of interest: fast spindle density, spindle duration and spindle amplitude. This resulted in three clusters, characterised by preserved spindle architecture with higher fast spindle density and longer spindle duration (Cluster 1), and alterations in spindle architecture (Clusters 2 and 3). These clusters were further characterised by reduced memory (Clusters 2 and 3) and nocturnal hypoxemia, associated with sleep apnea (Cluster 3). Resting state fMRI analysis confirmed that default mode connectivity was related to spindle architecture, although directionality of this relationship differed across the cluster groups. Together these results confirm a diversity in spindle architecture in older adults, associated with clinically meaningful phenotypes, including memory function and sleep apnea. They suggest that resting state default mode connectivity during the awake state can be associated with sleep spindle architecture, however this is highly dependent on clinical phenotype. Establishing relationships between clinical and neuroimaging features and sleep spindle alterations, will advance our understanding of the bidirectional relationships between sleep changes and neurodegenerative diseases of ageing.

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Section: Discussionsupporting

confidence: 68%

Sleep spindle architecture associated with distinct clinical phenotypes in older adults at risk for dementia

Orlando

O’Callaghan

Lam

et al. 2023

Preprint

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“…This suggests that these vascular risk factors may account for considerable variance in the relationship between clinical ADHD and 10-year dementia risk; additional prospective longitudinal studies will be needed to validate these findings in adults across the ADHD symptom severity spectrum, with richer cognitive and behavioural outcomes. Further, there has been increasing recognition of other medical and physical conditions in ADHD 12 , 76 that were not examined here but that may also contribute to cognitive changes into later adulthood, such as liver disease 77 , epilepsy 78 and obstructive sleep apnea 79 . These conditions should be explored as potential mediators in future work.…”

Section: Discussionmentioning

confidence: 99%

Contribution of vascular risk factors to the relationship between ADHD symptoms and cognition in adults and seniors

Callahan

Plamondon

Gill

et al. 2021

Sci Rep

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Symptoms of attention-deficit/hyperactivity disorder (ADHD) in childhood have been found to be predictive of compromised cognitive function, and possibly even dementia, in later adulthood. This study aimed to test vascular risk as a hypothesized moderator or mediator of this association, because individuals with elevated ADHD symptoms frequently have comorbid vascular disease or risk factors which are recognized to contribute to later-life cognitive decline. Data from 1,092 adults aged 18–85 were drawn from the Enhanced Nathan Kline Institute Rockland Sample. Childhood ADHD symptoms (assessed using the Adult ADHD Clinical Diagnostic Scale) were assessed as predictors of cognitive functioning in adulthood (assessed using subtests from the University of Pennsylvania Computerized Neurocognitive Battery, the Delis-Kaplan Executive Functioning System, and the Wechsler Memory Scale). Vascular risk factors (including diabetes, tobacco use, obesity, hypertension, and hypercholesterolemia) were tested as both a moderator and mediator of this relationship. Childhood ADHD symptoms and vascular risk factors were both independently associated with later-life cognition, but vascular risk was not a significant moderator or mediator of relationships between ADHD symptoms and cognition in statistical models. Results from this large community sample suggest that the relationship between ADHD symptoms and cognition is not accounted for by vascular risk. This question should also be investigated in clinical samples.

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“…There appears to be a synergistic relationship between sleepdisordered breathing and Alzheimer's disease because they share certain etiological and physiopathological determinants that predispose them to the development of both disorders in the same patient (Figure 2) [34,82]. First, the presence of OSA, sleep fragmentation, and nocturnal hypoxia are linked with higher cognitive impairments such as decreased memory, attention, and executive function [83][84][85][86], symptoms inherent in AD. Furthermore, it was found that the more severe the form of OSA, the stronger the association between the apnea-hypopnea index, the oxygen desaturation index, and the prediction of memory impairment [87].…”

Section: Bidirectional Relationship Between Obstructive Sleep Apnea A...mentioning

confidence: 99%

Respiratory Dysfunction in Alzheimer’s Disease—Consequence or Underlying Cause? Applying Animal Models to the Study of Respiratory Malfunctions

Wrzesień,

Andrzejewski,

Jampolska

et al. 2024

IJMS

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Alzheimer’s disease (AD) is a neurodegenerative brain disease that is the most common cause of dementia among the elderly. In addition to dementia, which is the loss of cognitive function, including thinking, remembering, and reasoning, and behavioral abilities, AD patients also experience respiratory disturbances. The most common respiratory problems observed in AD patients are pneumonia, shortness of breath, respiratory muscle weakness, and obstructive sleep apnea (OSA). The latter is considered an outcome of Alzheimer’s disease and is suggested to be a causative factor. While this narrative review addresses the bidirectional relationship between obstructive sleep apnea and Alzheimer’s disease and reports on existing studies describing the most common respiratory disorders found in patients with Alzheimer’s disease, its main purpose is to review all currently available studies using animal models of Alzheimer’s disease to study respiratory impairments. These studies on animal models of AD are few in number but are crucial for establishing mechanisms, causation, implementing potential therapies for respiratory disorders, and ultimately applying these findings to clinical practice. This review summarizes what is already known in the context of research on respiratory disorders in animal models, while pointing out directions for future research.

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The Link Between Obstructive Sleep Apnoea and Neurodegeneration and Cognition

Cited by 8 publications

References 57 publications

Sleep spindle architecture associated with distinct clinical phenotypes in older adults at risk for dementia

Sleep spindle architecture associated with distinct clinical phenotypes in older adults at risk for dementia

Contribution of vascular risk factors to the relationship between ADHD symptoms and cognition in adults and seniors

Respiratory Dysfunction in Alzheimer’s Disease—Consequence or Underlying Cause? Applying Animal Models to the Study of Respiratory Malfunctions

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