Obstructive Sleep Apnea and Postoperative Cognitive Decline in Non-Cardiac Surgery: A Prospective Cohort Study

Area of Science:

• Anesthesiology and Perioperative Medicine
• Neurology
• Sleep Medicine

Background:

• Obstructive sleep apnea (OSA) is a potential risk factor for postoperative cognitive decline (POCD).
• The association between OSA severity and POCD requires further investigation in non-cardiac surgery patients.

Purpose of the Study:

• To investigate the relationship between obstructive sleep apnea severity and postoperative cognitive decline.
• To identify risk factors for POCD in patients undergoing elective non-cardiac surgery.

Main Methods:

• Prospective observational study including adult patients undergoing elective non-cardiac surgery.
• Cognitive function assessed pre- and post-surgery using verbal fluency, digit symbol substitution, and word list recall tests.
• Long-term cognitive function evaluated at 30 and 90 days post-surgery using the Telephone Interview for Cognitive Status.

Main Results:

• No significant association was found between moderate to severe obstructive sleep apnea and increased risk of postoperative cognitive decline (p = 0.339).
• Postoperative cognitive decline incidence was 18.5% within 2 days after surgery.
• A history of depression was identified as an independent risk factor for postoperative cognitive decline (p = 0.045).

Conclusions:

• The severity of obstructive sleep apnea does not appear to be associated with postoperative cognitive decline within 90 days.
• Preoperative depression is a significant risk factor for postoperative cognitive decline.
• Clinical management of patients with depression requires careful consideration to mitigate POCD risk.