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Updated: Jun 10, 2026
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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Glymphatic system dysfunction in obstructive sleep apnea with mild cognitive impairment evidenced by DTI-ALPS
Danyang Li1, Xiangbo Yan2, Xiaoying Zhu3
1Dalian Medical University, Dalian, China; Imaging Department, Affiliated Zhongshan Hospital Dalian University, Dalian, China.
Sleep Medicine
|June 8, 2026
Summary
Obstructive sleep apnea with mild cognitive impairment (OSA-MCI) shows glymphatic dysfunction, impacting cognitive function. The ALPS index effectively measures this dysfunction and helps distinguish OSA-MCI patients.
Area of Science:
- Neuroimaging
- Sleep Medicine
- Neurology
Background:
- Obstructive sleep apnea (OSA) is linked to cognitive decline.
- The glymphatic system clears waste from the brain, and its dysfunction may contribute to cognitive impairment in OSA.
Purpose of the Study:
- To investigate glymphatic system alterations using DTI-ALPS in OSA patients with mild cognitive impairment (OSA-MCI).
- To explore the relationship between glymphatic function, OSA severity, and cognitive performance.
Main Methods:
- Diffusion tensor image analysis along the perivascular space (DTI-ALPS) was performed on 27 OSA-MCI patients, 27 OSA patients without MCI (OSA-nMCI), and 20 good sleepers (GS).
- Participants underwent cognitive assessments (MoCA), diffusion MRI, and polysomnography (PSG).
- ALPS indices were calculated and correlated with cognitive scores, apnea-hypopnea index (AHI), and minimal oxygen saturation (MinSpO2).
Main Results:
- OSA-MCI patients exhibited significantly reduced ALPS indices compared to OSA-nMCI and GS groups.
- Mediation analysis indicated that OSA severity exacerbates cognitive impairment through glymphatic dysfunction (ALPS index).
- The ALPS index demonstrated preliminary discriminative ability between OSA and OSA-MCI patients.
Conclusions:
- Glymphatic dysfunction, measured by ALPS indices, is present in OSA-MCI patients.
- This dysfunction is associated with OSA severity and contributes to cognitive impairment.
- The ALPS index shows potential as a biomarker for distinguishing OSA-MCI from OSA.
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