Dataset Information

Obstructive sleep apnea, verbal memory, and executive function in a community-based high-risk population identified by the Berlin Questionnaire Akershus Sleep Apnea Project.

ABSTRACT:

Purpose

Cognitive functions in community-dwelling adults at high risk of obstructive sleep apnea have not been described and nor are associations between cognitive functions and obstructive sleep apnea severity fully understood. The study aimed to describe verbal memory and executive function in community-dwelling adults identified by the Berlin Questionnaire and to investigate associations between these cognitive domains and different obstructive sleep apnea severity indicators.

Methods

Among 29,258 age- and gender-stratified persons 30-65 years who received the Berlin Questionnaire by mail, 16,302 (55.7%) responded. From 654 randomly drawn respondents with BQ high risk who were approached for study participation, 290 participants (55.9% males, mean age 48.2 years) were included. Verbal memory was assessed by Rey Auditory Verbal Learning Test and executive function by Stroop test. Obstructive sleep apnea severity indicators were assessed by polysomnography.

Results

Mean (standard deviation) verbal learning score was 42.0 (8.9), mean interference time was 31.1 (12.7), median (25th percentile, 75th percentile) apnea-hypopnea index was 7.7 (2.4-22.2), and mean average oxygen saturation was 94.3 (2.0). Verbal learning score was independently associated with average oxygen saturation (? = 0.721, p = 0.025) in multivariate linear regression models adjusted for putative confounders. Interference time was only related to OSA severity indicators in bivariate analyses.

Conclusions

Verbal memory and executive function impairments were mild in community-dwelling adults at high risk of obstructive sleep apnea. Average oxygen saturation was the indicator of obstructive sleep apnea severity most strongly associated with cognitive function.

SUBMITTER: Hrubos-Strom H

PROVIDER: S-EPMC3278612 | biostudies-literature | 2012 Mar

REPOSITORIES: biostudies-literature

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Publications

Obstructive sleep apnea, verbal memory, and executive function in a community-based high-risk population identified by the Berlin Questionnaire Akershus Sleep Apnea Project.

Hrubos-Strøm Harald H Nordhus Inger H IH Einvik Gunnar G Randby Anna A Omland Torbjørn T Sundet Kjetil K Moum Torbjørn T Dammen Toril T

Sleep & breathing = Schlaf & Atmung 20110225 1

<h4>Purpose</h4>Cognitive functions in community-dwelling adults at high risk of obstructive sleep apnea have not been described and nor are associations between cognitive functions and obstructive sleep apnea severity fully understood. The study aimed to describe verbal memory and executive function in community-dwelling adults identified by the Berlin Questionnaire and to investigate associations between these cognitive domains and different obstructive sleep apnea severity indicators.<h4>Meth ...[more]

PMID: 21350844

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Project description:Study objectivesTo validate the previously published National Healthy Sleep Awareness Project (NHSAP) Surveillance and Epidemiology Workgroup questionnaire for ability to determine risk for moderate to severe obstructive sleep apnea (OSA).MethodsThe NHSAP sleep questions, part of the next Behavioral Risk Factor Surveillance System (BRFSS), were constructed to mimic elements of the STOP sleep apnea questionnaire, and included number of days with sleep disruption and unintentional dozing and a history of snoring and apneas. The responses to four sleep questions from the BRFSS were collected from 352 adults undergoing in-laboratory polysomnography at Mayo Clinic, Rochester, Minnesota. Demographic and clinical information, including sex, age, body mass index (BMI), and presence of hypertension, which will be available in other parts of the complete BRFSS, were obtained by chart review. Univariate and logistic regression analyses were performed, and values of P < .05 were considered to be statistically significant.ResultsFifty-five percent of subjects were men and 45% were women with a median age of 58 years and BMI 32.2 kg/m2. Sixty percent had no or mild OSA, and 40% had moderate to severe OSA. No single question was superior in screening for moderate to severe OSA, although a history of snoring and witnessed apneas was more likely to predict moderate to severe OSA. Male sex, age ? 50 years, BMI ? 30 kg/m2, presence of hypertension, and a history of snoring and witnessed apneas were the most highly weighted factors in predicting moderate to severe OSA. When each variable was dichotomized to a single point, a cutoff of 5 points significantly predicted a high risk of moderate to severe OSA with an odds ratio of 3.87 (2.39-6.27).ConclusionsAlthough many variables were positively associated with the apnea-hypopnea index, no single factor was superior in predicting moderate to severe OSA. Male sex, increased age, higher BMI, hypertension, and a history of snoring and witnessed apneas are the most highly predictive of moderate to severe OSA. Combined use of the NHSAP questionnaire and demographic and clinical characteristics could be considered for screening for moderate to severe OSA.

Project description:RationaleAlthough cognitive deficits are well documented in patients with sleep apnea, the impact on memory remains unclear.ObjectivesTo test the hypotheses that (1) patients with obstructive sleep apnea have memory impairment and (2) memory impairment is commensurate with disease severity.MethodsPatients with obstructive sleep apnea and healthy volunteers (apnea-hypopnea index <5 events/h) completed a test battery specially designed to differentiate between aspects of memory (semantic, episodic, and working) versus attention. Sleepiness was measured on the basis of the Epworth Sleepiness Scale and Oxford Sleep Resistance test. Memory performance in patients versus control subjects was compared (Mann-Whitney U test; P < 0.01, Bonferroni corrected for multiple comparisons) and relationships between performance and disease severity were analyzed by linear regression.Measurements and main resultsSixty patients and healthy control subjects matched for age (mean +/- SD: patients, 51 +/- 9 yr; control subjects, 50 +/- 9 yr) and education (patients, 14 +/- 3 yr; control subjects, 15 +/- 3 yr) participated. Patients demonstrated impaired Logical Memory Test results (immediate recall: patients, median [range], 36 [9-69]; control subjects, 43 [19-64], P = 0.0004; and delayed recall: patients, 22 [6-42]; control subjects, 27 [10-46]; P = 0.0001). There were minimal differences in attention, visual episodic, semantic, or working memory; patients performed better than control subjects on Spatial Span forward and backward. Regression analysis revealed that Logical Memory Test performance was not significantly related to disease severity after controlling for age, education, and sleepiness.ConclusionsObstructive sleep apnea is associated with impairment in verbal, but not visual, memory. The impairment was present across a range of disease severity and was not explained by reduced attention. Such verbal memory impairment may affect daytime functioning and performance.

Dataset Information

Obstructive sleep apnea, verbal memory, and executive function in a community-based high-risk population identified by the Berlin Questionnaire Akershus Sleep Apnea Project.

Purpose

Methods

Results

Conclusions

Publications

Obstructive sleep apnea, verbal memory, and executive function in a community-based high-risk population identified by the Berlin Questionnaire Akershus Sleep Apnea Project.

Similar Datasets

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