Effects of Obstructive Sleep Apnea and Insomnia on Cognitive Function
Main Article Content
Abstract
Purpose of Review. Obstructive sleep apnea and chronic insomnia are the most common sleep disorders in adults. Both sleep disorders can adversely affect physical and mental well-being. Cognitive function has been extensively studied in relation to chronic insomnia and obstructive sleep apnea. This paper reviews the recent studies investigating the cognitive effects of insomnia and obstructive sleep apnea as well as the potential benefits of treatment.
Recent Findings. Recent studies indicate that insomnia is associated with impairments in attention, memory, and executive function. Chronic insomnia may have a moderating role in mild cognitive impairment and Alzheimer’s dementia. Mood and anxiety disorders may moderate the effects of insomnia on cognitive function. Hyperarousal and short sleep time associated with insomnia are risk factors for cognitive impairment. Cognitive behavior therapy for insomnia may improve cognitive function but more studies are needed. Nonbenzodiazepine receptor agonists improve insomnia without causing cognitive impairment. Benzodiazepine use is associated with cognitive impairment.
Obstructive sleep apnea is associated with impairments in attention, concentration, memory, and executive function with apnea severity as measured by the apnea hypopnea index and severity of nocturnal hypoxemia being the largest risk factors. Untreated obstructive sleep apnea may have a significant impact on the progression of mild cognitive impairment and Alzheimer’s dementia. The impact of obstructive sleep apnea treatment, particularly with continuous positive airway pressure, appears to mitigate and slow the rate of cognitive decline but more randomized controlled studies are needed.
Summary. Standardized cognitive assessments and larger, long-term controlled prospective studies with diverse populations are needed to further elucidate the cognitive impairments associated with chronic insomnia and obstructive sleep apnea. More studies are needed on the benefits of various treatments for obstructive sleep apnea and insomnia.
Keywords:
Obstructive sleep apnea, insomnia, cognition, attention, concentration, memory, continuous positive airway pressure (CPAP), continuous positive airway pressure (CPAP), and cognitive behavior therapy-insomnia, cognitive behavior therapy-insomnia, mild cognitive impairment, Alzheimer’s dementia
Article Details
How to Cite
SEDA, Gilbert; SHRIVASTAVA, Sharonya.
Effects of Obstructive Sleep Apnea and Insomnia on Cognitive Function.
Medical Research Archives, [S.l.], v. 11, n. 2, feb. 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/3578>. Date accessed: 21 dec. 2024.
doi: https://doi.org/10.18103/mra.v11i2.3578.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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2. American Academy of Sleep Medicine. International classification of sleep disorders, 3rd ed. Darien, IL: American Academy of Sleep Medicine 2014.
3. Sutton EL. Insomnia. Ann Intern Med. 2021 Mar;174(3):ITC33-ITC48. doi: 10.7326/AITC202103160. Epub 2021 Mar 9. PMID: 33683929.
4. Zaheed AB, Chervin RD, Spira AP, Zahodne LB. Mental and Physical Health Pathways Linking Insomnia Symptoms to Cognitive Performance 14 Years Later. Sleep. 2022 Oct 30:zsac262. doi: 10.1093/sleep/zsac262. Epub ahead of print. PMID: 36309871.
5. Resciniti NV, Yelverton V, Kase BE, Zhang J, Lohman MC. Time-Varying Insomnia Symptoms and Incidence of Cognitive Impairment and Dementia among Older US Adults. Int J Environ Res Public Health. 2021 Jan 5;18(1):351. doi: 10.3390/ijerph18010351. PMID: 33466468; PMCID: PMC7796486.
6. Beydoun HA, Beydoun MA, Weiss J, Hossain S, Huang S, Alemu BT, Zonderman AB. Insomnia as a predictor of diagnosed memory problems: 2006-2016 Health and Retirement Study. Sleep Med. 2021 Apr;80:158-166. doi: 10.1016/j.sleep.2021.01.038. Epub 2021 Feb 2. PMID: 33601227.
7. Xu W, Tan CC, Zou JJ, Cao XP, Tan L; Alzheimer’s Disease Neuroimaging Initiative. Insomnia Moderates the Relationship Between Amyloid-β and Cognitive Decline in Late-Life Adults without Dementia. J Alzheimers Dis. 2021;81(4):1701-1710. doi: 10.3233/JAD-201582. PMID: 33967043.
8. Baril AA, Beiser AS, Sanchez E, Mysliwiec V, Redline S, Gottlieb DJ, O'Connor GT, Gonzales MM, Himali D, Seshadri S, Himali JJ, Pase MP. Insomnia symptom severity and cognitive performance: Moderating role of APOE genotype. Alzheimers Dement. 2022 Mar;18(3):408-421. doi: 10.1002/alz.12405. Epub 2021 Jul 26. PMID: 34310026; PMCID: PMC8802306.
9. Olaithe M, Ree M, McArdle N, Donaldson S, Pushpanathan M, Eastwood PR, Bucks RS. Cognitive Dysfunction in Insomnia Phenotypes: Further Evidence for Different Disorders. Front Psychiatry. 2021 Jul 19;12:688672. doi: 10.3389/fpsyt.2021.688672. PMID: 34349682; PMCID: PMC8326515.
10. Khassawneh BY, Bathgate CJ, Tsai SC, Edinger JD. Neurocognitive performance in insomnia disorder: The impact of hyperarousal and short sleep duration. J Sleep Res. 2018 Dec;27(6):e12747. doi: 10.1111/jsr.12747. Epub 2018 Aug 1. PMID: 30069961.
11. Etholén A, Pietiläinen O, Kouvonen A, Hänninen M, Rahkonen O, Lallukka T. Trajectories of Insomnia Symptoms Among Aging Employees and Their Associations With Memory, Learning Ability, and Concentration After Retirement - A Prospective Cohort Study (2000-2017). J Aging Health. 2022 Oct;34(6-8):916-928. doi: 10.1177/08982643221078740. Epub 2022 Apr 28. PMID: 35482013; PMCID: PMC9483690.
12. Chunhua X, Jiacui D, Xue L, Kai W. Impaired emotional memory and decision-making following primary insomnia. Medicine (Baltimore). 2019 Jul;98(29):e16512. doi: 10.1097/MD.0000000000016512. PMID: 31335727; PMCID: PMC6709269.
13. Brownlow JA, Klingaman EA, Boland EM, Brewster GS, Gehrman PR. Psychiatric disorders moderate the relationship between insomnia and cognitive problems in military soldiers. J Affect Disord. 2017 Oct 15;221:25-30. doi: 10.1016/j.jad.2017.06.023. Epub 2017 Jun 13. PMID: 28628764.
14. Dagher M, Farchakh Y, Barbar S, Haddad C, Akel M, Hallit S, Obeid S. Association between problematic social media use and memory performance in a sample of Lebanese adults: the mediating effect of anxiety, depression, stress and insomnia. Head Face Med. 2021 Feb 23;17(1):6. doi: 10.1186/s13005-021-00260-8. PMID: 33622360; PMCID: PMC7901207.
15. Borchgrevink P, Inge Landrø N. The Effect of Insomnia on Neuropsychological Functioning in Patients with Comorbid Symptoms of Pain, Fatigue, and Mood Disorders. Arch Clin Neuropsychol. 2018 Feb 1;33(1):14-23. doi: 10.1093/arclin/acx040. PMID: 28453603; PMCID: PMC5860517.
16. Cross NE, Carrier J, Postuma RB, Gosselin N, Kakinami L, Thompson C, Chouchou F, Dang-Vu TT. Association between insomnia disorder and cognitive function in middle-aged and older adults: a cross-sectional analysis of the Canadian Longitudinal Study on Aging. Sleep. 2019 Aug 1;42(8):zsz114. doi: 10.1093/sleep/zsz114. PMID: 31089710; PMCID: PMC6685318.
17. Zhao JL, Cross N, Yao CW, Carrier J, Postuma RB, Gosselin N, Kakinami L, Dang-Vu TT. Insomnia disorder increases the risk of subjective memory decline in middle-aged and older adults: a longitudinal analysis of the Canadian Longitudinal Study on Aging. Sleep. 2022 Nov 9;45(11):zsac176. doi: 10.1093/sleep/zsac176. PMID: 35877203; PMCID: PMC9644124.
18. Unsal P, Sengul Aycicek G, Deniz O, Esme M, Dikmeer A, Balcı C, Koca M, Ucar Y, Boga I, Burkuk S, Halil MG, Cankurtaran M, Dogu BB. Insomnia and falls in older adults: are they linked to executive dysfunction? Psychogeriatrics. 2021 May;21(3):359-367. doi: 10.1111/psyg.12677. Epub 2021 Mar 8. PMID: 33684960.
19. Teräs T, Rovio S, Spira AP, Myllyntausta S, Pulakka A, Vahtera J, Stenholm S. Associations of accelerometer-based sleep duration and self-reported sleep difficulties with cognitive function in late mid-life: the Finnish Retirement and Aging Study. Sleep Med. 2020 Apr;68:42-49. doi: 10.1016/j.sleep.2019.08.024. Epub 2019 Sep 20. PMID: 32028225.
20. Grau-Rivera O, Operto G, Falcón C, Sánchez-Benavides G, Cacciaglia R, Brugulat-Serrat A, Gramunt N, Salvadó G, Suárez-Calvet M, Minguillon C, Iranzo Á, Gispert JD, Molinuevo JL; ALFA Study. Association between insomnia and cognitive performance, gray matter volume, and white matter microstructure in cognitively unimpaired adults. Alzheimers Res Ther. 2020 Jan 7;12(1):4. doi: 10.1186/s13195-019-0547-3. PMID: 31907066; PMCID: PMC6945611.
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