Impact of obstructive sleep apnea on cognitive performance

OBJECTIVE: To evaluate the impact of obstructive sleep apnea (OSA) on cognition. METHOD: We compared the performance of 17 patients with polysomnographic diagnosis of OSA in brief cognitive tests to that of 20 healthy controls, matched for age and education. The testing battery included the Mini-Mental State Examination (MMSE), Brief Cognitive Screening Battery (BCSB), Digit-Symbol (DS) and Phonemic Verbal Fluency (FAS). Anthropometric measures and scores from the Epworth Sleepiness Scale were also recorded. RESULTS: OSA patients performed significantly worse than controls in the MMSE, in memory items from the BCSB, in DS and also in FAS. OSA patients also exhibited higher body mass index, increased neck circumference and higher scores in Epworth Sleepiness Scale than controls. CONCLUSION: OSA significantly impairs cognitive performance, especially within the domains of attention, memory and executive functioning. These deficits may be detected by brief and easy-to-administer cognitive tests.

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Faculty Opinions recommendation of The impact of bariatric surgery on obstructive sleep apnea: a systematic review.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717983971.793494037 ◽

2014 ◽

Author(s):

Neil Freedman

Keyword(s):

Systematic Review ◽

Bariatric Surgery ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep ◽

The Impact

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Faculty Opinions recommendation of Diagnostic accuracy of the Berlin questionnaire, STOP-BANG, STOP, and Epworth sleepiness scale in detecting obstructive sleep apnea: A bivariate meta-analysis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.727144766.793544466 ◽

2018 ◽

Author(s):

Frances Chung

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Diagnostic Accuracy ◽

Epworth Sleepiness Scale ◽

Meta Analysis ◽

Berlin Questionnaire ◽

Obstructive Sleep

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Aerodynamics Analysis of the Impact of Nasal Surgery on Patients with Obstructive Sleep Apnea and Nasal Obstruction

ORL ◽

10.1159/000516243 ◽

2021 ◽

pp. 1-8

Author(s):

Lifeng Li ◽

Demin Han ◽

Hongrui Zang ◽

Nyall R. London

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Nasal Obstruction ◽

Upper Airway ◽

Apnea Hypopnea Index ◽

Nasal Surgery ◽

Subjective Sleep Quality ◽

Obstructive Sleep ◽

Significant Difference ◽

The Impact

Objective: The purpose of this study was to evaluate the effects of nasal surgery on airflow characteristics in patients with obstructive sleep apnea (OSA) by comparing the alterations of airflow characteristics within the nasal and palatopharyngeal cavities. Methods: Thirty patients with OSA and nasal obstruction who underwent nasal surgery were enrolled. A pre- and postoperative 3-dimensional model was constructed, and alterations of airflow characteristics were assessed using the method of computational fluid dynamics. The other subjective and objective clinical indices were also assessed. Results: By comparison with the preoperative value, all postoperative subjective symptoms statistically improved (p < 0.05), while the Apnea-Hypopnea Index (AHI) changed little (p = 0.492); the postoperative airflow velocity and pressure in both nasal and palatopharyngeal cavities, nasal and palatopharyngeal pressure differences, and total upper airway resistance statistically decreased (all p < 0.01). A significant difference was derived for correlation between the alteration of simulation metrics with subjective improvements (p < 0.05), except with the AHI (p > 0.05). Conclusion: Nasal surgery can decrease the total resistance of the upper airway and increase the nasal airflow volume and subjective sleep quality in patients with OSA and nasal obstruction. The altered airflow characteristics might contribute to the postoperative reduction of pharyngeal collapse in a subset of OSA patients.

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The Impact of Adenotonsillectomy on Sleep and Behavior of Children with Obstructive Sleep Apnea

Indian Journal of Otolaryngology and Head & Neck Surgery ◽

10.1007/s12070-021-02593-x ◽

2021 ◽

Author(s):

Arya Ajith ◽

Renuka Balu ◽

Madhumita Kumar ◽

Siddharth Panikkar

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep ◽

And Behavior ◽

The Impact

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Validity and Cost-Effectiveness of Pediatric Home Respiratory Polygraphy for the Diagnosis of Obstructive Sleep Apnea in Children: Rationale, Study Design, and Methodology

Methods and Protocols ◽

10.3390/mps4010009 ◽

2021 ◽

Vol 4 (1) ◽

pp. 9

Author(s):

Esther Oceja ◽

Paula Rodríguez ◽

María Jurado ◽

Maria Luz Alonso ◽

Genoveva del Río ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Cost Effectiveness ◽

Sleep Apnea ◽

Therapeutic Interventions ◽

Diagnostic Process ◽

Urine Biomarkers ◽

Obstructive Sleep ◽

Respiratory Polygraphy ◽

The Cost ◽

The Impact

Obstructive sleep apnea (OSA) in children is a prevalent, albeit largely undiagnosed disease associated with a large spectrum of morbidities. Overnight in-lab polysomnography remains the gold standard diagnostic approach, but is time-consuming, inconvenient, and expensive, and not readily available in many places. Simplified Home Respiratory Polygraphy (HRP) approaches have been proposed to reduce costs and facilitate the diagnostic process. However, evidence supporting the validity of HRP is still scarce, hampering its implementation in routine clinical use. The objectives were: Primary; to establish the diagnostic and therapeutic decision validity of a simplified HRP approach compared to PSG among children at risk of OSA. Secondary: (a) Analyze the cost-effectiveness of the HRP versus in-lab PSG in evaluation and treatment of pediatric OSA; (b) Evaluate the impact of therapeutic interventions based on HRP versus PSG findings six months after treatment using sleep and health parameters and quality of life instruments; (c) Discovery and validity of the urine biomarkers to establish the diagnosis of OSA and changes after treatment.

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Subjective and Objective Appraisal of Activity in Adults with Obstructive Sleep Apnea

Journal of Aging Research ◽

10.4061/2011/751819 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 19

Author(s):

Eileen R. Chasens ◽

Susan M. Sereika ◽

Martin P. Houze ◽

Patrick J. Strollo

Keyword(s):

Physical Activity ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Epworth Sleepiness Scale ◽

Functional Outcomes ◽

Apnea Hypopnea Index ◽

Sleep Study ◽

Obstructive Sleep ◽

Subjective Sleepiness ◽

Aging Adults

Objective.This study examined the association between obstructive sleep apnea (OSA), daytime sleepiness, functional activity, and objective physical activity.Setting.Subjects (N=37) being evaluated for OSA were recruited from a sleep clinic.Participants. The sample was balanced by gender (53% male), middle-aged, primarily White, and overweight or obese with a mean BMI of 33.98 (SD=7.35;median BMI=32.30). Over 40% reported subjective sleepiness (Epworth Sleepiness Scale (ESS) ≥10) and had OSA (78% with apnea + hypopnea index (AHI) ≥5/hr).Measurements.Evaluation included questionnaires to evaluate subjective sleepiness (Epworth Sleepiness Scale (ESS)) and functional outcomes (Functional Outcomes of Sleep Questionnaire (FOSQ)), an activity monitor, and an overnight sleep study to determine OSA severity.Results.Increased subjective sleepiness was significantly associated with lower scores on the FOSQ but not with average number of steps walked per day. A multiple regression analysis showed that higher AHI values were significantly associated with lower average number of steps walked per day after controlling patient's age, sex, and ESS.Conclusion.Subjective sleepiness was associated with perceived difficulty in activity but not with objectively measured activity. However, OSA severity was associated with decreased objective physical activity in aging adults.

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Cardiovascular outcomes of CPAP therapy in obstructive sleep apnea syndrome

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.00401.2007 ◽

2007 ◽

Vol 293 (4) ◽

pp. R1666-R1670 ◽

Cited By ~ 36

Author(s):

Walter T. McNicholas

Keyword(s):

Cardiovascular Disease ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep Apnea Syndrome ◽

Sleep Apnea Syndrome ◽

Cpap Therapy ◽

Obstructive Sleep ◽

Cardiovascular Morbidity And Mortality ◽

Apnea Syndrome ◽

The Impact

Considerable evidence is now available of an independent association between obstructive sleep apnea syndrome (OSAS) and cardiovascular disease. The association is particularly strong for systemic arterial hypertension, but there is growing evidence of an association with ischemic heart disease and stroke. The mechanisms underlying cardiovascular disease in patients with OSAS are still poorly understood. However, the pathogenesis is likely to be a multifactorial process involving a diverse range of mechanisms, including sympathetic overactivity, selective activation of inflammatory molecular pathways, endothelial dysfunction, abnormal coagulation, and metabolic dysregulation, the latter particularly involving insulin resistance and disordered lipid metabolism. Therapy with continuous positive airway pressure (CPAP) has been associated with significant benefits to cardiovascular morbidity and mortality, both in short-term studies addressing specific aspects of morbidity, such as hypertension, and more recently in long-term studies that have evaluated major outcomes of cardiovascular morbidity and mortality. However, there is a clear need for further studies evaluating the impact of CPAP therapy on cardiovascular outcomes. Furthermore, studies on the impact of CPAP therapy have provided useful information concerning the role of basic cell and molecular mechanisms in the pathophysiology of OSAS.

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