Neurocognitive and Neuropsychological Efects of OSA
Obstructive sleep apnea (OSA) is often associated with neuropsychological changes and cognitive impairment. While sleepiness and hypoxemia are both likely contributors to cognitive changes, the effects of OSA exceed what would be expected from these factors alone. Vascular changes related to hypertension and hyperlipidemia can play a role in the cognitive changes, as well as alterations in insulin, cortisol, leptin, and testosterone secretion or sensitivity. Finally, chronic inflammation is present in OSA, which is an additional risk factor for cognitive decline. As a result of these underlying derangements, patients with OSA show changes in attention and executive function, and the effect of OSA on mood is well documented. There are also data to suggest visuospatial impairments related to OSA. Data on learning and memory and on language functions are less conclusive. This chapter reviews the domains of cognition most commonly affected by OSA and the underlying mechanisms by which they occur. In addition, this chapter discusses the neuroimaging data used to analyze structural changes to the brain in OSA and the impacts of positive airway pressure therapy.
