Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr 1;18(4):1177-1185.
doi: 10.5664/jcsm.9832.

The association between obstructive sleep apnea risk and cognitive disorders: a population-based study

Monica M Shieu  1 , Galit Levi Dunietz  1 , Henry L Paulson  2 , Ronald D Chervin  1 , Tiffany J Braley  1
Affiliations

The association between obstructive sleep apnea risk and cognitive disorders: a population-based study

Monica M Shieu et al. J Clin Sleep Med. .

Abstract

Study objectives: To examine the association between obstructive sleep apnea (OSA) risk and cognitive disorders among US adults.

Methods: Data from the 2016 wave of the Health and Retirement Study (HRS) were utilized. Probable OSA cases were identified with survey items that resembled critical elements of a clinically validated OSA screen (STOP-Bang questionnaire). Weighted prevalences of cognitive impairment not dementia (CIND) and dementia among individuals with and without probable OSA were assessed. Cross-sectional analyses of associations between OSA risk and cognitive outcomes, along with effect modification by race and ethnicity, were estimated using imputed data.

Results: Of the 20,910 HRS participants, 60% had probable OSA. CIND and dementia were more common among adults with probable OSA as compared with those without (12.7% vs 8.0% for CIND; 3.2% vs 2.0% for dementia). Probable OSA was associated with CIND (odds ratio [OR] = 1.22, 95% confidence interval [CI] = 1.08-1.37) and dementia (OR = 1.27, 95% CI = 1.04-1.54). Race/ethnicity significantly modified the association between probable OSA and CIND, with a higher risk for CIND in Whites (OR = 1.35, 95% CI = 1.17-1.57) as compared with non-Whites (OR = 0.98, 95% CI = 0.81-1.19).

Conclusions: CIND and dementia are more common among older adults who are at high risk for OSA, as compared with low-risk individuals. These data highlight the importance of consideration of OSA risk in large-scale studies of OSA and cognitive disorders.

Citation: Shieu MM, Dunietz GL, Paulson HL, Chervin RD, Braley TJ. The association between obstructive sleep apnea risk and cognitive disorders: a population-based study. J Clin Sleep Med. 2022;18(4):1177-1185.

Keywords: cognitive disorders; dementia; effect modification; obstructive sleep apnea.

PubMed Disclaimer

Conflict of interest statement

All authors have seen and approved the manuscript. Work for this study was performed at the University of Michigan. Dr. Shieu is supported by a T32 grant from National Heart, Lung, and Blood Institute (T32 HL110952). Drs. Braley and Dunietz report funding from the National Institute on Aging, Award Number R01AG074342. Dr. Braley also receives funding from the National Center for Complementary and Integrative Health (Award Number R01AT011341) and the Patient-Centered Outcomes Research Institute (Award Number MS-1610-36980). She is named in a patent, held by the University of Michigan, concerning a treatment for sleep apnea. She completed a sleep apnea clinical trial that received material support, but no financial support, from Biogen-Idec. She is also site principal investigator for several industry-funded studies of MS immunotherapeutics at the University of Michigan (Genentech-Roche). She has done consulting work for Greenwich Biosciences. Dr. Chervin has received research funding from the National Institutes of Health (HL105999 and NS099043). He is named in or has developed materials, patented and copyrighted by the University of Michigan, and designed to assist with assessment or treatment of sleep disorders. He has served on the boards of the American Academy of Sleep Medicine, Associated Professional Sleep Societies, American Board of Sleep Medicine, American Academy of Sleep Medicine Foundation (which funded the current research), International Pediatric Sleep Society, and the nonprofit Sweet Dreamzzz. He is an author and editor for UpToDate, has edited a book for Cambridge University Press, and has consulted for Zansors. Dr. Paulson reports no conflicts of interest.

Figures

Figure 1
Figure 1. Distribution of composite cognitive scores and each individual test score by number of positive STOP-Bang items.
See this image and copyright information in PMC

References

    1. Plassman BL , Langa KM , Fisher GG , et al. . Prevalence of dementia in the United States: the aging, demographics, and memory study . Neuroepidemiology. 2007. ; 29 ( 1–2 ): 125 – 132 . - PMC - PubMed
    1. Alzheimer Association . 2020 Alzheimer’s disease facts and figures . Alzheimers Dement. 2020. ; 16 ( 3 ): 391 – 460 .
    1. Albert MS , DeKosky ST , Dickson D , et al. . The diagnosis of mild cognitive impairment due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease . Alzheimers Dement. 2011. ; 7 ( 3 ): 270 – 279 . - PMC - PubMed
    1. Mubashir T , Abrahamyan L , Niazi A , et al. . The prevalence of obstructive sleep apnea in mild cognitive impairment: a systematic review . BMC Neurol. 2019. ; 19 ( 1 ): 195 . - PMC - PubMed
    1. Lee JE , Yang SW , Ju YJ , Ki SK , Chun KH . Sleep-disordered breathing and Alzheimer’s disease: a nationwide cohort study . Psychiatry Res. 2019. ; 273 : 624 – 630 . - PubMed

Publication types