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Obstructive sleep apnea

Impact of hypoxemia on memory

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Abstract

Purpose

Attempts to understand the causes of cognitive impairment in obstructive sleep apnea (OSA) are complicated by the overlap among clinical and demographic factors that may impact cognition. The goal of the current study was to isolate the contribution of hypoxemia to cognitive impairment in OSA.

Methods

Two groups of 20 patients with newly diagnosed OSA were compared. The groups differed on severity of hypoxemia but not other demographic (e.g., age, gender, education, estimated premorbid IQ) or clinical (e.g., sleep related respiratory disturbances, daytime sleepiness, depressive symptoms) variables. Participants completed polysonmography and cognitive assessment.

Results

We compared patients with high and low hypoxemia on measures of memory, attention, executive functioning, and motor coordination using independent sample t-tests. The high hypoxemia group performed significantly better on immediate recall (Hopkins Verbal Learning Test — Revised; t = −2.50, p < 0.02) than the low hypoxemia group. No group differences were observed on other neuropsychological measures.

Conclusions

This study is one of the first to compare the cognitive performance of patients with high and low hypoxemia after controlling for demographic factors and aspects of OSA severity that could confound the relationship. In our carefully matched sample, we observed an unexpected advantage of higher hypoxemia on memory. These preliminary findings are discussed in the context of basic science literature on the protective effects of adaptation to intermittent hypoxemia. Our data suggest that the association between hypoxemia and cognition may not straightforward. Future research targeting the effects of hypoxemia on cognition controlling for other clinical factors in large groups of patients with OSA will be important.

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Acknowledgements

This work was supported by the National Institutes of Health [Grant HL067209]. Dr. Aloia takes responsibility as the guarantor of the work presented in the manuscript. All authors assisted in reviewing and editing of the manuscript. Additionally, Dr. Hoth, Ms. Meschede, Dr. Zimmerman, and Dr. Aloia engaged in data analysis and interpretation, Dr. Aloia and Dr. Zimmerman contributed to the design of the study, and Dr. Arnedt assisted in data collection. The authors acknowledge Dr. Richard P. Millman, Leisha Smith, Jaime Skrekas, Sarah Harris, and Charleen Pysz for assistance with patient recruitment, neuropsychological assessment, and data entry.

Conflict of interest

Dr. Zimmerman has received investigator-initiated research funding from Merck Sharp and Dohme Corp., and Bristol-Myers Squibb. Dr. Aloia is a paid employee and stockholder for Philips/Respironics, Inc.

Author information

Authors and Affiliations

  1. National Jewish Health, Department of Medicine, 1400 Jackson Street, Denver, CO, USA

    Karin F. Hoth, Kimberly A. Meschede & Mark S. Aloia

  2. Departments of Psychiatry and Neurology, University of Colorado School of Medicine, Denver, CO, USA

    Karin F. Hoth

  3. Albert Einstein College of Medicine, Department of Neurology, Bronx, NY, USA

    Molly E. Zimmerman

  4. Departments of Psychiatry and Neurology, University of Michigan Medical School, Ann Arbor, MI, USA

    J. Todd Arnedt

  5. Clinical Research, Philips/Respironics, Inc., Murrysville, PA, USA

    Mark S. Aloia

Authors
  1. Karin F. Hoth
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  2. Molly E. Zimmerman
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  3. Kimberly A. Meschede
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  4. J. Todd Arnedt
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  5. Mark S. Aloia
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Correspondence to Karin F. Hoth.

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Institutions at which work was performed: Brown University, Rhode Island Hospital, National Jewish Health

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Hoth, K.F., Zimmerman, M.E., Meschede, K.A. et al. Obstructive sleep apnea. Sleep Breath 17, 811–817 (2013). https://doi.org/10.1007/s11325-012-0769-0

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  • DOI: https://doi.org/10.1007/s11325-012-0769-0

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