Michael Devinney
Assistant Professor of Anesthesiology

Delirium and cognitive dysfunction following surgery are associated with significant long-term risk for dementia, diminished quality of life, and increased mortality. Yet, few interventions exist to prevent these neurocognitive disorders, in part due to our poor understanding of their pathophysiologic underpinnings and risk factors. One possible risk factor is obstructive sleep apnea (OSA), a disorder characterized by repeated breathing interruptions during sleep that is highly prevalent yet frequently undiagnosed in older adults. One way that OSA could increase risk of postoperative neurocognitive disorders is through increased neuroinflammation. To better understand the relationship between OSA, postoperative neurocognitive disorders and neuroinflammation, we are carrying out a prospective observational cohort study called Sleep Apnea, Neuroinflammation, and cognitive Dysfunction Manifesting After Non-cardiac surgery (SANDMAN). In SANDMAN, patients undergo preoperative home sleep apnea testing in addition to pre- and postoperative cognitive testing, delirium screening, and cerebrospinal fluid sampling. This work has the potential to shed insight into crucial mechanisms of brain injury in OSA patients that could increase risk for postoperative delirium and cognitive dysfunction.

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