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Cognition in Obstructive Sleep Apnea-Hypopnea Syndrome (OSAS): Current Clinical Knowledge and the Impact of Treatment

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Abstract

Obstructive sleep apnea-hypopnea syndrome (OSAS) is characterized by the presence of disordered breathing events that occur during sleep, as well as symptoms such as sleepiness and snoring. OSAS is associated with a number of adverse health consequences, and a growing literature focuses on its cognitive correlates. Although research in this field is mixed, multiple studies indicate that OSAS patients show impairment in attention, memory, and executive function. Continuous positive airway pressure (CPAP) is the most effective and widely used treatment of OSAS, and supplemental medications may supplement CPAP treatment to ameliorate associated symptoms. Here, we review the literature on OSAS and cognition, including studies that have investigated the impact of CPAP and stimulant medication on cognitive performance in patients with OSAS. In general, no consistent effect of CPAP use on cognitive performance was evident. This may be due, in part, to variability in study design and sampling methodology across studies. Studies of stimulant medications generally reported positive effects on cognitive performance. We conclude with a discussion of the mechanisms that have been proposed to explain cognitive dysfunction in OSAS and directions for future research.

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Acknowledgments

Dr. Spira is supported by a Mentored Research Scientist Development Award (K01AG033195) from the National Institute on Aging. Dr. Ancol-Israel is supported by NIA AG08415, UL1RR031980 (CTRI), the UCSD Stein Institute for Research on Aging and the Department of Veterans Affairs Center of Excellence for Stress and Mental Health (CESAMH).

Conflict of interest

Dr. Ancoli-Israel has consulted for Astra Zeneca, Ferring Pharmaceuticals Inc., GlaxoSmithKline, Johnson & Johnson, Merck, NeuroVigil, Inc., Pfizer, Philips, Purdue Pharma LP, sanofi-aventis, Somaxon, Dr. Rebok and Ms. Kielb declare that they have no conflict of interest.

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  1. Department of Neurology, Johns Hopkins School of Medicine, 1620 McElderry Street, Reed Hall 2-East, Baltimore, MD, 21205, USA

    Stephanie A. Kielb

  2. Departments of Psychiatry and Medicine, University of California, San Diego, CA, USA

    Sonia Ancoli-Israel

  3. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    George W. Rebok & Adam P. Spira

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Correspondence to Stephanie A. Kielb.

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Kielb, S.A., Ancoli-Israel, S., Rebok, G.W. et al. Cognition in Obstructive Sleep Apnea-Hypopnea Syndrome (OSAS): Current Clinical Knowledge and the Impact of Treatment. Neuromol Med 14, 180–193 (2012). https://doi.org/10.1007/s12017-012-8182-1

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