Obstructive Sleep Apnea and Neurocognitive Function

Is OSA Associated with a Decline in NCF? The data regarding associations between OSA and a NCF decline are mixed. Some of the limitations of evaluating existing studies in the literature are that a majority have small sample sizes, a diverse group of NCF tests and protocols have been reported, and in the case of controlled trials, different shams or placebos have been utilized. There are several studies on the effects of OSA on NCF,1-26 and key reviews of the OSA and NCF literature include those by Engleman, et al.27 and Saunamäki and Jehkonen.28 These studies typically assessed NCF within three primary domains: 1) measures of attention and psychomotor function (A/P), 2) measures of learning and memory (L/M), and 3) measures of executive and frontal-lobe function (E/F). In general, particularly in the earlier studies, review of these studies indicated that community-acquired participants with mild indices of sleep-disordered breathing (SDB) showed slight attentional and executive function impairment. Those studies with moderate and severe SDB indices revealed moderate and large impairment in all areas of NCF. However, relatively small sample sizes and inadequate control groups handicapped the majority of these studies. Another limitation for earlier studies is that newer technologies, such as the Sustained Attention Metric29-33 and functional MRI, were not used to evaluate NCF in OSA patients.