Sleep and Breathing

, Volume 17, Issue 2, pp 811–817

Obstructive sleep apnea

Impact of hypoxemia on memory
  • Karin F. Hoth
  • Molly E. Zimmerman
  • Kimberly A. Meschede
  • J. Todd Arnedt
  • Mark S. Aloia
Original Article

DOI: 10.1007/s11325-012-0769-0

Cite this article as:
Hoth, K.F., Zimmerman, M.E., Meschede, K.A. et al. Sleep Breath (2013) 17: 811. doi:10.1007/s11325-012-0769-0



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.


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.


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.


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.



Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Karin F. Hoth
    • 1
    • 2
  • Molly E. Zimmerman
    • 3
  • Kimberly A. Meschede
    • 1
  • J. Todd Arnedt
    • 4
  • Mark S. Aloia
    • 1
    • 5
  1. 1.National Jewish Health, Department of MedicineDenverUSA
  2. 2.Departments of Psychiatry and NeurologyUniversity of Colorado School of MedicineDenverUSA
  3. 3.Albert Einstein College of Medicine, Department of NeurologyBronxUSA
  4. 4.Departments of Psychiatry and NeurologyUniversity of Michigan Medical SchoolAnn ArborUSA
  5. 5.Clinical Research, Philips/Respironics, Inc.MurrysvilleUSA