Association between sleep microarchitecture and cognition in obstructive sleep apnea
Andrew E Beaudin1,2, Magdy Younes3,4, Bethany Gerardy4
1Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Sleep
|June 29, 2024
Summary
Obstructive sleep apnea (OSA) is linked to cognitive decline. Specific EEG sleep measures, like spindle activity, may help identify at-risk patients and understand the mechanisms behind this cognitive impairment.
Area of Science:
- Neurology
- Sleep Medicine
- Cognitive Neuroscience
Background:
- Obstructive sleep apnea (OSA) is a prevalent condition associated with an increased risk of cognitive impairment.
- Early identification of individuals with OSA at risk for cognitive complications is crucial for timely intervention.
- Electroencephalography (EEG) measures of sleep microarchitecture offer potential biomarkers for cognitive dysfunction in OSA.
Purpose of the Study:
- To investigate the association between specific EEG sleep microarchitecture parameters and cognitive function in individuals with suspected OSA.
- To determine if sleep microarchitecture indices mediate the relationship between OSA severity and cognitive performance.
Main Methods:
- A cohort of 1142 participants with suspected OSA underwent polysomnography and cognitive testing (MoCA, RAVLT, DSC).
- EEG measures including sleep spindle density, power, frequency, %-fast spindles, odds-ratio product (ORP), normalized EEG power (EEGNP), and delta:alpha ratio were analyzed.
- Multivariable linear regression and mediation analyses were employed to assess associations and mediation effects, adjusting for relevant covariates.
Main Results:
- Reduced sleep spindle characteristics (density, power, frequency, %-fast) were observed in moderate-to-severe OSA patients and correlated positively with cognitive scores (MoCA, RAVLT, DSC), except for spindle power with RAVLT.
- Odds-ratio product during NREM sleep (ORPNREM) was elevated in severe OSA but not significantly associated with cognitive scores.
- Mediation analyses indicated that spindle density and EEGNP partially mediated the effect of OSA on MoCA scores, while ORPNREM, spindle power, and %-fast spindles mediated the effect on DSC scores.
Conclusions:
- Altered sleep spindle activity, ORP, and normalized EEG power are implicated as significant contributors to cognitive deficits in patients with OSA.
- These EEG-derived sleep microarchitecture measures may serve as valuable biomarkers for cognitive impairment associated with OSA.
- Understanding these mechanisms can inform targeted therapeutic strategies for cognitive dysfunction in OSA.
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