Cognitive complaints in obstructive sleep Apnea: The overlooked role of coping styles

Cognitive complaints are common in obstructive sleep apnea (OSA) but do not correlate with objective cognitive impairments, leaving their underlying cause unclear. The present study aims to (1) compare coping styles between OSA patients and healthy controls, and (2) investigate the relationship between cognitive complaints and various coping styles in OSA patients.

In a cross-sectional design, cognitive complaints and coping styles were compared between OSA patients (n = 24) and healthy controls (n = 15). Validated questionnaires were used to assess cognitive complaints (Cognitive Failure Questionnaire, CFQ; Behavior Rating Inventory of Executive Function for adults, BRIEF-A) and coping styles (Utrecht Coping List, UCL). Additional variables included demographics, indicators of OSA severity, sleep quality, subjective sleepiness, anxiety, depression, and cognitive impairments. Pearson correlations were used to identify variables associated with cognitive complaints. These variables were then included as controls in hierarchical regression analyses to determine the unique contribution of coping styles to explaining cognitive complaints.

Compared to healthy controls, OSA patients reported more cognitive complaints on the CFQ and reported a more passive coping style. In OSA patients, reduced active problem-solving on the UCL was independently associated with higher CFQ scores (β = -.43), regardless of AHI, anxiety or depression symptoms. Avoidant (β = .49) coping styles were independently linked to higher BRIEF-A scores. Coping styles accounted for 51 %-59 % of the variance in cognitive complaints among OSA patients.

Psychological mechanisms, specifically avoidant and less pro-active coping styles, significantly contribute to cognitive complaints in OSA, independent of OSA severity and symptoms of anxiety and depression. Psychological interventions improving coping skills may benefit OSA patients experiencing cognitive complaints.

clinicaltrials.gov, NCT02769663.