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Obstructive sleep apnea-hypopnea and neurocognitive functioning in the Sleep Heart Health Study.

TitleObstructive sleep apnea-hypopnea and neurocognitive functioning in the Sleep Heart Health Study.
Publication TypeJournal Article
Year of Publication2006
AuthorsQuan, SF, Wright, R, Baldwin, CM, Kaemingk, KL, Goodwin, JL, Kuo, TF, Kaszniak, A, Boland, LL, Caccappolo, E, Bootzin, RR
JournalSleep Med
Volume7
Issue6
Pagination498-507
Date Published2006 Sep
ISSN1389-9457
KeywordsBrain, Cognition Disorders, Continuous Positive Airway Pressure, Demography, Disorders of Excessive Somnolence, Electromyography, Electrooculography, Female, Health Status, Humans, Hypoxia, Male, Middle Aged, Neuropsychological Tests, Oxygen, Polysomnography, Severity of Illness Index, Sleep Apnea, Obstructive, Surveys and Questionnaires
Abstract<p><b>BACKGROUND AND PURPOSE: </b>Obstructive sleep apnea-hypopnea (OSAH) is associated with sleep fragmentation and nocturnal hypoxemia. In clinical samples, patients with OSAH frequently are found to have deficits in neuropsychological function. However, the nature and severity of these abnormalities in non-clinical populations is less well defined.</p><p><b>PATIENTS AND METHODS: </b>One hundred and forty-one participants from the Tucson, AZ and New York, NY field centers of the Sleep Heart Health Study completed a battery of neuropsychological tests for 9-40 months (mean=24 months, SD=7 months) after an unattended home polysomnogram. Sixty-seven participants had OSAH (AHI>10) and 74 did not have OSAH (control (CTL), apnea-hypopnea index (AHI)<5). In addition to the individual tests, composite variables representing attention, executive function, MotorSpeed and processing speed were constructed from the neuropsychological test battery.</p><p><b>RESULTS: </b>There were no significant differences in any individual neuropsychological test or composite variable between the OSAH and CTL groups. However, when time spent with O(2) saturations less than 85% was dichotomized into those participants in the top quartile of the distribution and those in the lower three quartiles, motor speed was significantly impaired in those who were more hypoxemic. In addition, poorer motor speed (model adjusted R(2)=0.242, P<0.001) and processing speed performance (model adjusted R(2)=0.122, P<0.001) were associated with more severe oxygen desaturation even after controlling for degree of daytime sleepiness, age, gender and educational level.</p><p><b>CONCLUSIONS: </b>Mild to moderate OSAH has little impact on the selected measures of attention, executive function, motor speed and processing speed. However, hypoxemia adversely affects both motor and processing speed. These results suggest that in middle-aged to elderly adults the neuropsychological effects of clinically unrecognized mild to moderate OSAH are neither global nor large.</p>
DOI10.1016/j.sleep.2006.02.005
Alternate JournalSleep Med
PubMed ID16815753
Grant ListU01HL53937 / HL / NHLBI NIH HHS / United States
U01HL64360 / HL / NHLBI NIH HHS / United States
U01HL53938 / HL / NHLBI NIH HHS / United States
U01 HL053938 / HL / NHLBI NIH HHS / United States
U01HL53934 / HL / NHLBI NIH HHS / United States
U01HL63429 / HL / NHLBI NIH HHS / United States
U01HL53931 / HL / NHLBI NIH HHS / United States
U01HL53941 / HL / NHLBI NIH HHS / United States
U01HL53916 / HL / NHLBI NIH HHS / United States
U01HL53940 / HL / NHLBI NIH HHS / United States
U01HL63463 / HL / NHLBI NIH HHS / United States