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Polysomnographic risk factors for vigilance-related cognitive decline and obstructive sleep apnea

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

Cognitive decline (CD) and obstructive sleep apnea (OSA) are often comorbid. Some modifiable risk factors (RF) for CD are also associated with OSA. Diagnostic polysomnography (PSG) measures these RF and may identify at risk patients prior to the onset of CD. We aim to determine whether there are severe RF associated with established CD and an increasing severity of OSA that could identify patients at risk for CD for medical intervention.

Methods

We gathered information from subjects having type 1 PSG for suspected OSA. The psychomotor vigilance task (PVT) measured established CD (group 0 and group1). We compared levels of severe RF in group 0 and group 1 with a larger group (group 2) without the PVT. We used severe standardized values of excessive daytime sleepiness (Epworth Sleepiness Score [ESS]), overnight change of systolic blood pressure (ΔSBP), change of oxygen desaturation (ΔSpO2), and sleep arousal (ArI) as RF. We compared the severe levels of ESS, ΔSBP, ΔSpO2, and ArI by group and OSA severity.

Results

A total of 136 patients underwent diagnostic PSG. PVT parameters were available for 43 subjects. The severity of the RF was consistent with risk for CD (ΔSBP 22.0 ± 5.6, ESS 18.2 ± 2.2, ArI 58.8 ± 18.7, ΔSpO2 61.7 ± 21.9). The levels of RF increased with increasing severity of OSA. There were significant between-group differences for severe ΔSpO2 (p = 0.004) and ΔSpO2 + ArI (p = 0.019).

Conclusion

The levels of RF increase with increasing OSA severity. Subjects with severe RF ΔSpO2 and ΔSpO2 + ArI are likely to have PVT-determined CD. Risk factor analysis may screen for CD.

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Acknowledgments

We would like to thank the staff and patients of the Princess Alexandra Hospital Sleep Disorders Centre.

Funding

This research was supported by the National Health and Medical Research Council (NHMRC) under grant APP1126600.

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Authors and Affiliations

  1. Department of Information Technology and Electrical Engineering, University of Queensland, Brisbane, Australia

    Karen McCloy, Vinayak Swarnkar & Udantha Abeyratne

  2. Department of Respiratory and Sleep Medicine, Princess Alexandra Hospital, Brisbane, Australia

    Brett Duce & Craig Hukins

  3. Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia

    Brett Duce

Authors
  1. Karen McCloy
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  2. Brett Duce
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  3. Vinayak Swarnkar
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  4. Craig Hukins
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  5. Udantha Abeyratne
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Corresponding author

Correspondence to Karen McCloy.

Ethics declarations

All procedures performed in this study complied with the 1964 Helsinki declaration and its later amendments, and this study has approval from the Human Research Ethics Committees of the Metro South Hospital and Health Services and The University of Queensland. All subjects gave informed consent.

Conflict of interest

The University of Queensland has filed a patent on the NHMRC materials; inventors not named yet. Some authors of the current paper may be named as inventors.

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McCloy, K., Duce, B., Swarnkar, V. et al. Polysomnographic risk factors for vigilance-related cognitive decline and obstructive sleep apnea. Sleep Breath 25, 75–83 (2021). https://doi.org/10.1007/s11325-020-02050-z

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  • DOI: https://doi.org/10.1007/s11325-020-02050-z

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