<p>Moderate-to-Severe Obstructive Sleep Apnea and Cognitive Function Impairment in Patients with COPD</p>

Abstract

Prior studies have indicated that patients with chronic obstructive pulmonary disease (COPD) exhibit significant cognitive defects on neuropsychological testing. Obstructive sleep apnea (OSA) is common in patients with COPD and is associated with reduced cognitive function; however, the combined impact of these two conditions on cognitive function is unknown. The aim of the study was to investigate the impact of OSA on cognitive impairment in patients with COPD. Methods: Sixty-five stable COPD patients aged over 60 years underwent overnight polysomnography (PSG). Global cognitive functions were evaluated using the Mini-Mental State Examination (MMSE). Results: Compared to patients with COPD alone, patients with both COPD and OSA performed worse on the MMSE (25.5±2.9 vs 23.5±3.2; p=0.01) and were more likely to be at risk for developing dementia based on the MMSE score (MMSE≤24) (31% vs 66%; p<0.01), independent of key demographic, educational and medical variables known to affect cognitive function in COPD. COPD patients with an apnea hypopnea index (AHI) of ≥30 events/h had lower MMSE scores than those with an AHI of <15 events/h. In addition to age and education level, the severity of nocturnal intermittent hypoxia is an independent predictor of the risk of dementia in patients with COPD (OR=1.24, 95% CI 1.04-1.48, p = 0.02). Conclusion: The current findings indicate that patients with COPD with comorbid OSA may be at greater risk for global cognitive impairment relative to patients with COPD alone. The mechanisms underlying the exaggerated cognitive dysfunction seem to be related to intermittent hypoxia. Further work is needed to understand the impact of OSA on the specific domains of cognitive impairment and the therapeutic implications of OSA in COPD.

Evaluation of nocturnal apnea and airflow limitation as indicators for cognitive dysfunction in patients with chronic obstructive pulmonary disease/obstructive sleep apnea hypopnea syndrome overlap syndrome

“…Previous studies showed that the MoCA score was significantly lower and the risk of dementia was dramatically higher in OS patients compared with COPD-only patients. 14 , 19 Additionally, the level of dementia in OS patients was significantly correlated with the severity of OSA. 19 Therefore, it is of great importance to screen cognitive impairment in OS patients at early stage by using appropriate indicators.…”

“… 14 , 19 Additionally, the level of dementia in OS patients was significantly correlated with the severity of OSA. 19 Therefore, it is of great importance to screen cognitive impairment in OS patients at early stage by using appropriate indicators.…”

Association between cardiopulmonary function, health-related quality of life and cognitive impairment among the older nursing home residents in Shanghai, China

“…About 18% of CI patients experience respiratory dysfunction (Martinez et al, 2014), and 43% of cognitive decline patients have heart failure (HF) (Cannon et al, 2017). Accumulating evidence from different countries not only indicates abnormal cardiopulmonary function increased the risk of cognitive impairment (Emery et al, 2012;Cermakova et al, 2015;Jefferson et al, 2015;Zhang et al, 2020;Duong et al, 2022) but also reveals the complex interactions between cognitive impairment and HRQOL (Ezzati et al, 2019;Liu et al, 2019;Phyo et al, 2021). Currently, the mechanisms of abnormal cardiac function and cognitive impairment mainly involve cerebral hypoperfusion, hypoxia, systemic inflammation, endothelial injury and neurohormonal activation (Cermakova et al, 2015;Diener et al, 2019) and of abnormal pulmonary function and cognitive impairment mainly involved hypoxia, systemic inflammation and cerebral vascular dysfunction (Wang et al, 2020).…”

Contribution of Obstructive Sleep Apnoea to Cognitive Functioning of Males With Coronary Artery Disease: A Relationship With Endocrine and Inflammatory Biomarkers

“…Obstructive sleep apnoea (OSA) represents an independent risk factor for adverse cardiac outcomes and impaired cognitive functioning, especially in men ( Zhang et al, 2020 ). Several unfavorable medical conditions have been associated with OSA, for example coronary artery disease (CAD), heart failure, atrial fibrillation, hypertension, stroke ( Goudis and Ketikoglou, 2017 ; Li et al, 2018 ; Salman et al, 2020 ; Roderjan et al, 2022 ), metabolic dysfunction ( Bonsignore et al, 2013 ), and neurocognitive impairment ( Seda and Han, 2020 ).…”