Abstract
Purpose
Medications can impact cognitive function. Obstructive sleep apnea syndrome (OSAS) is associated with cognitive impairment. There is currently a paucity of data evaluating the impact of medications on sleep architecture and cognition in untreated OSAS. Our objective was to evaluate the impact of obstructive sleep apnea syndrome (OSAS) and medications on cognition by a screening questionnaire called the Mail-In Cognitive Function Screening Instrument (MCFSI).
Methods
We conducted a retrospective chart review on consecutive adults (age > 18 years) with OSAS seen in Medical University of South Carolina Sleep Clinic between January 1, 2012 and May 8, 2013, for whom the Mail-In Cognitive Function Screening Instrument (MCFSI) score was available and who were not on continuous positive airway pressure (CPAP). The correlation between different medications, sleep study variables, and MCFSI scores was studied.
Results
Univariate analysis revealed that many medications had significant correlations with MCFSI scores, including antidepressants (p = 0.05), antipsychotics (p = 0.01), anxiolytics (p = 0.005), statins (p = 0.077) and narcotics (p = 0.006). The mean percentage of rapid eye movement (REM) sleep (p = 0.04) and Epworth Sleepiness Scale (p = 0.01) were also significantly correlated with MCFSI scores. Multivariate analysis revealed that Epworth Sleepiness Scale and use of antipsychotics, narcotics, and anxiolytics correlated with higher MCFSI scores (worse cognition) and conversely that statin use was associated with improved cognition.
Conclusions
Medications have a significant impact on cognitive function in OSAS. Thus, medication use should be considered in future studies of cognitive function in patients with OSAS.
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Ethical standards
This study was approved by the Medical University of South Carolina’s Institutional Review Board, and waiver of informed consent was obtained. Therefore, this study was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
Conflicts of interest
Dr. Lal has received grant funding from Invado Pharmaceuticals. Dr. Siddiqi, Dr. Kumbhare, and Dr. Strange have no conflicts of interest to disclose.
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Lal, C., Siddiqi, N., Kumbhare, S. et al. Impact of medications on cognitive function in obstructive sleep apnea syndrome. Sleep Breath 19, 939–945 (2015). https://doi.org/10.1007/s11325-014-1105-7
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DOI: https://doi.org/10.1007/s11325-014-1105-7