TY - JOUR
T1 - Obstructive sleep apnea, cognition and Alzheimer's disease
T2 - A systematic review integrating three decades of multidisciplinary research
AU - Bubu, Omonigho M.
AU - Andrade, Andreia G.
AU - Umasabor-Bubu, Ogie Q.
AU - Hogan, Megan M.
AU - Turner, Arlener D.
AU - de Leon, Mony J.
AU - Ogedegbe, Gbenga
AU - Ayappa, Indu
AU - Jean-Louis G, Girardin
AU - Jackson, Melinda L.
AU - Varga, Andrew W.
AU - Osorio, Ricardo S.
PY - 2020/4
Y1 - 2020/4
N2 - Increasing evidence links cognitive-decline and Alzheimer's disease (AD) to various sleep disorders, including obstructive sleep apnea (OSA). With increasing age, there are substantial differences in OSA's prevalence, associated comorbidities and phenotypic presentation. An important question for sleep and AD researchers is whether OSA's heterogeneity results in varying cognitive-outcomes in older-adults compared to middle-aged adults. In this review, we systematically integrated research examining OSA and cognition, mild cognitive-impairment (MCI) and AD/AD biomarkers; including the effects of continuous positive airway pressure (CPAP) treatment, particularly focusing on characterizing the heterogeneity of OSA and its cognitive-outcomes. Broadly, in middle-aged adults, OSA is often associated with mild impairment in attention, memory and executive function. In older-adults, OSA is not associated with any particular pattern of cognitive-impairment at cross-section; however, OSA is associated with the development of MCI or AD with symptomatic patients who have a higher likelihood of associated disturbed sleep/cognitive-impairment driving these findings. CPAP treatment may be effective in improving cognition in OSA patients with AD. Recent trends demonstrate links between OSA and AD-biomarkers of neurodegeneration across all age-groups. These distinct patterns provide the foundation for envisioning better characterization of OSA and the need for more sensitive/novel sleep-dependent cognitive assessments to assess OSA-related cognitive-impairment.
AB - Increasing evidence links cognitive-decline and Alzheimer's disease (AD) to various sleep disorders, including obstructive sleep apnea (OSA). With increasing age, there are substantial differences in OSA's prevalence, associated comorbidities and phenotypic presentation. An important question for sleep and AD researchers is whether OSA's heterogeneity results in varying cognitive-outcomes in older-adults compared to middle-aged adults. In this review, we systematically integrated research examining OSA and cognition, mild cognitive-impairment (MCI) and AD/AD biomarkers; including the effects of continuous positive airway pressure (CPAP) treatment, particularly focusing on characterizing the heterogeneity of OSA and its cognitive-outcomes. Broadly, in middle-aged adults, OSA is often associated with mild impairment in attention, memory and executive function. In older-adults, OSA is not associated with any particular pattern of cognitive-impairment at cross-section; however, OSA is associated with the development of MCI or AD with symptomatic patients who have a higher likelihood of associated disturbed sleep/cognitive-impairment driving these findings. CPAP treatment may be effective in improving cognition in OSA patients with AD. Recent trends demonstrate links between OSA and AD-biomarkers of neurodegeneration across all age-groups. These distinct patterns provide the foundation for envisioning better characterization of OSA and the need for more sensitive/novel sleep-dependent cognitive assessments to assess OSA-related cognitive-impairment.
KW - Alzheimer's disease
KW - Amyloid
KW - Biomarkers
KW - Cognition
KW - Middle aged
KW - Mild cognitive impairment
KW - Obstructive sleep apnea
KW - Older adults
KW - Phosphorylated tau
UR - http://www.scopus.com/inward/record.url?scp=85076673594&partnerID=8YFLogxK
U2 - 10.1016/j.smrv.2019.101250
DO - 10.1016/j.smrv.2019.101250
M3 - Review Article
AN - SCOPUS:85076673594
VL - 50
JO - Sleep Medicine Reviews
JF - Sleep Medicine Reviews
SN - 1087-0792
M1 - 101250
ER -