The Prevalence of Obstructive Sleep Apnea in Mild Cognitive Impairment: A Systematic Review

Abstract

Background: Previous studies have shown that obstructive sleep apnea (OSA) is associated with a higher risk of cognitive impairment or dementia in the elderly, leading to deleterious health effects and decreasing quality of life. This systematic review aims to determine the prevalence of OSA in patients with mild cognitive impairment (MCI) and examine whether an association between OSA and MCI exists. Methods: We searched Medline, PubMed, Embase, Cochrane Central, Cochrane Database of Systematic Reviews, PsychINFO, Scopus, the Web of Science, ClinicalTrials.gov and the International Clinical Trials Registry Platform for published and unpublished studies. We included studies in adults with a diagnosis of MCI that reported on the prevalence of OSA. Two independent reviewers performed the abstract and full-text screening, data extraction and the study quality critical appraisal. Results: Five studies were included in the systematic review. Overall, OSA prevalence rates in patients with MCI varied between 11−71% and were influenced by OSA diagnostic methods and patient recruitment locations (community or clinic based). Among studies using the following OSA diagnostic measures– self-report, ApneaLink, Berlin Questionnaire and polysomnography– the OSA prevalence rates in MCI were 11%, 27%, 59% and 70%, respectively. In a community-based sample, the prevalence of OSA in patients with and without MCI was 27% and 26%, respectively. Conclusions: Based on limited evidence, the prevalence of OSA in patients with MCI is 27% and varies based upon OSA diagnostic methods and patient recruitment locations. Our findings provide an important framework for future studies to prospectively investigate the association between OSA and MCI among larger community-based cohorts and implement a standardized approach to diagnose OSA in memory clinics. PROSPERO registration: CRD42018096577

Obstructive sleep apnea and chronic pain as risk factors of cognitive impairment in elderly population: A study from Indonesia

“…Our data found that 67.4% of the elderly had high risk of developing OSA and 72.9% had MCI. A study in Chinese population found the OSA prevalence was 63.7% [21] and a study found that MCI prevalence among those with high risk of OSA was ranging from 11-70%, slightly lower from our study (72.9%) [21]. Our data suggests that age was not associated with cognitive impairment and this is different from a previous study [22].…”

The relationships between obstructive sleep apnea and psychiatric disorders: a narrative review

“…2. There is a high prevalence of OSA in mental disorders ranges: anxiety disorder from 6.4% [19] to 57.1% [15], depressive disorder around 21.5% [40], psychotic disorders from 5.1% to 57.1% [19,63,64], bipolar disorder from 4.6% [75] to 15% [66], cognitive impairment from 11% to 71% [32]. 3.…”

“…Beaudin et al in 2021 conducted a clinical cohort study in which they noted that CI was present in 47.9% of OSA patients and it increased with the severity of the symptoms [31]. In another systematic review, the prevalence of OSA in patients with mild cognitive impairment ranges from 11% to 71% [32]. The most affected areas in cognition are attention, episodic memory, working memory, executive functions, motor performance, and constructional abilities [27,28].…”

Risk factors and fraction of exhaled nitric oxide in obstructive sleep apnea in adults

“…Obstructive sleep apnea (OSA) is a breathing disorder disease, which causes temporary cessation of airflow for 10 s while continuing ventilation during patients’ sleeping. 1 OSA is present in 4% of men and in 2% of women. Intermittent arterial oxygen desaturation, nocturnal arousal, and sleep disorders occur after a recurrent obstructive upper airway.…”