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Neurocognitive Impairment in Obstructive Sleep Apnea
Abstract
Obstructive sleep apnea syndrome (OSAS) is a common disorder with far-reaching health implications. One of the major consequences of OSAS is an impact on neurocognitive functioning. Several studies have shown that OSAS has an adverse effect on inductive and deductive reasoning, attention, vigilance, learning, and memory. Neurocognitive impairment can be measured objectively with tests such as the Wechsler Adult Intelligence Scale-Revised, the Psychomotor Vigilance Task, the Steer Clear Performance Test, and tests of repetitive finger tapping. In children, OSAS may cause attention-deficit hyperactivity disorder in addition to behavioral problems and learning disabilities. Risk factors for cognitive impairment include increasing age, male sex, apolipoprotein E ε4 allele positivity, current cigarette smoking, obesity, hypertension, diabetes mellitus, metabolic syndrome, Down syndrome, hypothyroidism, significant alcohol consumption, stroke, and the use of psychoactive medications. At a cellular level, OSAS likely causes cognitive impairment through intermittent hypoxia, hormonal imbalance, and/or systemic inflammation, either independently or via the resultant endothelial dysfunction that occurs. Excessive daytime sleepiness should be measured and minimized in all studies of neurocognitive impairment. Recent studies have used functional and structural neuroimaging to delineate the brain areas affected in patients with OSAS with neurocognitive dysfunction. A common finding in several of these studies is decreased hippocampal volume. Other affected brain areas include the frontal and parietal lobes of the brain, which show focal reductions in gray matter. These changes can be reversed at least partially with the use of CPAP, which highlights the importance of early recognition and treatment of OSAS. The currently available data in this field are quite limited, and more research is needed.
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“sleep apnoea often presents as daytime sleepiness or non-restorative sleep (Alam et al., 2012; Cruz et al., 2012; Lal et al., 2012; Lee et al., 2012; Sunwoo et al., 2012) and sometimes as insomnia (Al-Jawder & Bahammam, 2012; Glidewell et al., 2012).”
From Addressing sleep disturbances: an opportunity to prevent cardiometabolic disease? (2014) · cites this paper as Lal et al., 2012
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Metadata
- Authors
- Lal, C., Strange, C., & Bachman, D.
- Affiliations
- Medical University of South Carolina (US)
- Corresponding author
- Lal, Chitra
- Venue
- Chest
- Publisher
- Elsevier BV
- Published
- 2012-06
- Volume
- 141
- Issue
- 6
- Pages
- 1601-1610
- ISSN
- 0012-3692 (ISSN-L)
- OpenAlex
- W2162688500
- Cited by
- 406
- References
- 83
- Citations by year
- 2026: 16 · 2025: 28 · 2024: 17 · 2023: 21 · 2022: 32 · 2021: 31 · 2020: 37 · 2019: 31 · 2018: 20 · 2017: 37 · 2016: 29 · 2015: 34 · 2014: 44 · 2013: 28
- FWCI
- 3.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- CHEST Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- obstructive sleep apnea, neurocognitive impairment, cognitive impairment, intermittent hypoxia, hippocampal volume, gray matter reduction, continuous positive airway pressure, attention, memory, excessive daytime sleepiness, risk factors, APOE ε4, endothelial dysfunction, systemic inflammation, neuroimaging
- MeSH terms
- Animals, Cognition Disorders, Humans, Neuropsychological Tests, Risk Factors, Sleep Apnea, Obstructive, Neuroimaging
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