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Meta-Analysis
. 2013 Feb 1;36(2):203-20.
doi: 10.5665/sleep.2374.

Memory and obstructive sleep apnea: a meta-analysis

Anna Wallace  1 , Romola S Bucks
Affiliations
Meta-Analysis

Memory and obstructive sleep apnea: a meta-analysis

Anna Wallace et al. Sleep. .

Abstract

Study objectives: To examine episodic memory performance in individuals with obstructive sleep apnea (OSA).

Design: Meta-analysis was used to synthesize results from individual studies examining the impact of OSA on episodic memory performance. The performance of individuals with OSA was compared to healthy controls or normative data.

Participants: Forty-two studies were included, comprising 2,294 adults with untreated OSA and 1,364 healthy controls. Studies that recorded information about participants at baseline prior to treatment interventions were included in the analysis.

Measurements: PARTICIPANTS WERE ASSESSED WITH TASKS THAT INCLUDED A MEASURE OF EPISODIC MEMORY: immediate recall, delayed recall, learning, and/or recognition memory.

Results: The results of the meta-analyses provide evidence that individuals with OSA are significantly impaired when compared to healthy controls on verbal episodic memory (immediate recall, delayed recall, learning, and recognition) and visuo-spatial episodic memory (immediate and delayed recall), but not visual immediate recall or visuo-spatial learning. When patients were compared to norms, negative effects of OSA were found only in verbal immediate and delayed recall.

Conclusions: This meta-analysis contributes to understanding of the nature of episodic memory deficits in individuals with OSA. Impairments to episodic memory are likely to affect the daily functioning of individuals with OSA.

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Figures

Figure 1
Figure 1
Flow chart of search, retrieval and inclusion process.
Figure 2
Figure 2
Memory assessments were categorized into these domains.
Figure 3
Figure 3
Summary of mean effect sizes for control-referenced and norm-referenced studies across the domains. Positive values indicate better performance by healthy controls or norms relative to individuals with OSA. Negative values indicate better performance by individuals with OSA compared to norms and controls. Effect size data are reported only for domains that included at least two studies. See Table 2 for a description of the domains; IR, immediate recall; DR, delayed recall.
Figure 4
Figure 4
Forest plot comparing the performance of OSA samples on verbal immediate recall compared to healthy controls. The last line of data in the table gives the averaged effect size estimate. SD, standard difference; SE, standard error; LL, lower limit; UL; upper limit; Z; Z-value; P, P-value.
Figure 5
Figure 5
Forest plot comparing the performance of OSA samples on verbal immediate recall compared to norms. The last line of data in the table gives the averaged effect size estimate. SD, standard difference; SE, standard error; LL, lower limit; UL; upper limit; Z; Z-value; P, P-value.
Figure 6
Figure 6
Forest plot comparing the performance of OSA samples on verbal delayed recall to healthy controls. The last line of data in the table gives the averaged effect size estimate. Combined outcome is the average of multiple measures within one study. SD, standard difference; SE, standard error; LL, lower limit; UL; upper limit; Z; Z-value; P, P-value.
Figure 7
Figure 7
Forest plot comparing the performance of OSA samples on verbal delayed recall to norms. The last line of data in the table gives the averaged effect size estimate. Combined outcome is the average of multiple measures within one study. SD, standard difference; SE, standard error; LL, lower limit; UL; upper limit; Z; Z-value; P, P-value.
Figure 8
Figure 8
Forest plot comparing the performance of OSA samples on verbal recognition to healthy controls. The last line of data in the table gives the averaged effect size estimate. Combined outcome is the average of multiple measures within one study. SD, standard difference; SE, standard error; LL, lower limit; UL; upper limit; Z; Z-value; P, P-value.
Figure 9
Figure 9
Forest plot comparing the performance of OSA samples on verbal recognition to norms. The last line of data in the table gives the averaged effect size estimate. SD, standard difference; SE, standard error; LL, lower limit; UL; upper limit; Z; Z-value; P, P-value.
Figure 10
Figure 10
Forest plot comparing the performance of OSA samples on verbal learning to healthy controls. The last line of data in the table gives the averaged effect size estimate. SD, standard difference; SE, standard error; LL, lower limit; UL; upper limit; Z; Z-value; P, P-value.
Figure 11
Figure 11
Forest plot comparing the performance of OSA samples on verbal learning to norms. The last line of data in the table gives the averaged effect size estimate. SD, standard difference; SE, standard error; LL, lower limit; UL; upper limit; Z; Z-value; P, P-value.
Figure 12
Figure 12
Forest plot comparing the performance of OSA samples on visuo-spatial immediate recall to healthy controls. The last line of data in the table gives the averaged effect size estimate. SD, standard difference; SE, standard error; LL, lower limit; UL; upper limit; Z; Z-value; P, P-value.
Figure 13
Figure 13
Forest plot comparing the performance of OSA samples on visuo-spatial immediate recall to norms. The last line of data in the table gives the averaged effect size estimate. SD, standard difference; SE, standard error; LL, lower limit; UL; upper limit; Z; Z-value; P, P-value.
Figure 14
Figure 14
Forest plots comparing the performance of OSA samples on visuo-spatial delayed recall to healthy controls. The last line of data in the table gives the averaged effect size estimate. Combined outcome is the average of multiple measures within one study. SD, standard difference; SE, standard error; LL, lower limit; UL; upper limit; Z; Z-value; P, P-value.
Figure 15
Figure 15
Forest plots comparing the performance of OSA samples on visuo-spatial delayed recall to norms. The last line of data in the table gives the averaged effect size estimate. SD, standard difference; SE, standard error; LL, lower limit; UL; upper limit; Z; Z-value; P, P-value.
Figure 16
Figure 16
Forest plot comparing the performance of OSA samples on visuo-spatial learning to healthy controls. The last line of data in the table gives the averaged effect size estimate. SD, standard difference; SE, standard error; LL, lower limit; UL; upper limit; Z; Z-value; P, P-value.
Figure 17
Figure 17
Forest plot comparing the performance of OSA samples on visual immediate recall to healthy controls. The last line of data in the table gives the averaged effect size estimate. SD, standard difference; SE, standard error; LL, lower limit; UL; upper limit; Z; Z-value; P, P-value.
Figure 18
Figure 18
Forest plot comparing the performance of OSA samples on visual immediate recall to norms. The last line of data in the table gives the averaged effect size estimate. SD, standard difference; SE, standard error; LL, lower limit; UL; upper limit; Z; Z-value; P, P-value.
See this image and copyright information in PMC

References

STUDIES INCLUDED IN THE META-ANALYSIS

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    1. Ayalon L, Ancoli-Israel S, Klemfuss Z, Shalauta MD, Drummond SPA. Increased brain activation during verbal learning in obstructive sleep apnea. Neuroimage. 2006;31:1817–25. - PubMed

References

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