Obstructive sleep apnea common among patients with cognitive impairment
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Obstructive sleep apnea, or OSA, is common among older adults with cognitive impairment, and it was associated lower scores on cognition tests and poorer sleep quality, researchers reported.
Previous research has shown that the treatable sleep disorder may accelerate Alzheimer’s disease pathogenesis.
These most recent findings, which were released early, will be presented at the virtual American Academy of Neurology Annual Meeting in April.
“Better sleep is beneficial to the brain and can improve cognitive skills. Yet in our study, we found that over half of the people with cognitive impairment had obstructive sleep apnea,” study researcher Mark Boulos, MD FRCPC CSCN(EEG) MSc, assistant professor and staff neurologist at Sunnybrook Health Science Centre, said in a press release. “We also found that those with the sleep disorder had lower scores on thinking and memory tests. Fully understanding how obstructive sleep apnea affects this population is important because with treatment, there is potential to improve thinking and memory skills as well as overall quality of life.”
Boulos and colleagues assessed 67 patients with cognitive impairment (mean age, 72.8 years; 44.8% men; mean BMI, 25.6 kg/m2) who had 4 or more hours of home sleep apnea test results available for analysis.
According to the researchers, OSA was identified in 52.2% of the adults. Logistic regression models showed that OSA was significantly associated with a lower Montreal Cognitive Assessment score (OR = 0.4). OSA also correlated with the degree of cognitive impairment and sleep quality measured by actigraphy, such as greater sleep onset latency, lower sleep effectiveness, more awakenings and decreased sleep time.
“People with cognitive impairment should be assessed for obstructive sleep apnea because it can be treated by using a continuous positive airway pressure (CPAP) machine that helps keep the airway open at night,” Boulos said. “However, not everyone who tries CPAP chooses to regularly use the therapy, and this may be a bigger challenge to people with thinking and memory problems.”
Boulos said future studies should examine ways to more easily diagnose and manage OSA in patients with cognitive impairment.
Perspective
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We know from previous research that problems with sleep may be associated with increased risk for cognitive impairment, including Alzheimer’s or other dementia. This study adds to the body of work connecting poor sleep and cognition. However, this study only shows an association, and does not suggest that all individuals who have poor sleep will have cognitive impairment.
A key next step for research — and one we are starting to see emerge — is exploring whether intervening in sleep disturbances will impact cognition.
It is recommended — not only for the health of the brain, but for overall health — that people get 7 to 9 hours of quality sleep per night. Physicians should talk to their patients about their sleep patterns — including experience of insomnia, sleep apnea or other sleep disruptions — to better understand their overall health.
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