Obstructive sleep apnea may have a significant impact on middle-aged cognitive decline

Obstructive sleep apnea (OSA) can cause cognitive changes early in middle age in otherwise healthy people, according to a study published in the journal American Science. frontier of sleep. This study notes that OSA is a multisystem debilitating chronic respiratory disorder that can lead to relatively consistent patterns of cognitive impairment.

Credit: sbw19 – Stock.adobe.com

Researchers have recently argued that cognitive impairment, particularly in middle-aged patients, may be driven by cardiovascular and metabolic comorbidities, rather than a separate OSA process. added.

“Cognitive functions have traditionally been defined as planning, problem-solving, mental flexibility (grouped as executive functions), visuospatial skills, processing speed, expressiveness and memory, in addition to the broad domains of attention and memory. Both are comprised of higher-order cognitive skill areas such as receptive language,” the study authors wrote. “Historically, a body of research suggests that OSA has profound effects on attention and vigilance, long-term verbal and visual memory, expressive and receptive language, visuospatial and constructive abilities. .”

This study shows that it is difficult to fully discriminate between cognition, OSA, and aging, and that aging is independently associated with physiological changes that predispose individuals to OSA. points out. This association may be due, in part, to changes in the morphology of the upper airway that may lead to decreased upper airway dilator muscle function during sleep onset, which may be associated with negative pressure independent of the body. may contribute to the tendency for upper airway collapse with age. Investigators said it was a mass index.

For this study, the authors sought to define the cognitive performance of a group of 27 middle-aged men with untreated OSA and no comorbidities and compare them with 7 matched controls ( AHI mean ± SD: 1.9 ± 1.4 events/hour, mean age 34.0 years). ± 9.3 years, mean BMI 23.8 ± 2.3 kg/m2). Of the 27 patients enrolled, 16 had mild OSA (AHI mean ± SD: 11.7 ± 4.0 events/hour, mean age 42.6 ± 8.2 years, mean BMI 26.7 ± 4.1 kg/m2), 11 One had severe OSA (AHI 41.8±20.7). events/hour, age: 46.9 ± 10.9 years, BMI: 28.0 ± 3.2 kg/m2).

Participants underwent home respiratory testing via the WatchPAT system and video polysomnography (vPSG) at a sleep center. Nocturnal vPSG recordings were based on the International 10:20 System, and 6 EEG channels were referenced to the mastoid for the purposes of PSG scoring. It was used in conjunction with electrooculography, submandibular electromyography, respiratory inductance plethysmography, nasal pressure sensor, oronasal thermistor, pulse oximeter, 2-lead ECG, position detector, and synchronized audiovisual recording. rice field.

Results showed that a cohort of patients had impaired executive function, visuospatial memory, and deficits in vigilant sustained attention, psychomotor, and impulse control. The researchers also for the first time observed effects on social cognition in a study group of middle-aged male OSA patients.

“Clear deficits were observed in tests investigating cognitive domains such as vigilance, executive function, short-term visual recognition memory, and social and emotional recognition, with the greatest number of differences between controls and those with severe OSA. ,” the study authors wrote. “Subjects with mild OSA performed better than those with severe OSA on most of the same tasks, but rarely worse than controls.”

The researchers found that sleep fragmentation and associated sleep deprivation in patients with OSA, particularly REM-related fragmentation, can damage individualized emotional nervous systems and confound discrimination of salient emotional and social cues. concluded that there is.

“In conclusion, a future multicenter, multimodal longitudinal study will not only confirm these findings, but will also show how these cognitive deficits may change over time in men and women with impairment from other comorbidities. We need to figure out how they interact,” the authors write.

reference

Gnoni V. et al. Marked cognitive changes in male patients with obstructive sleep apnea without comorbidities. frontier of sleep. DOI=10.3389/frsle.2023.1097946 https://www.frontiersin.org/articles/10.3389/frsle.2023.1097946. ISSN=2813-2890. Accessed June 6, 2023.