title: The association between obstructive sleep apnea and neurocognitive performance--the Apnea Positive Pressure Long-term Efficacy Study (APPLES).
abstract: OBJECTIVE
  To determine associations between obstructive sleep apnea (OSA) and neurocognitive performance in a large cohort of adults.
  
  
  METHODS
  Cross-sectional analyses of polysomnographic and neurocognitive data from 1204 adult participants with a clinical diagnosis of obstructive sleep apnea (OSA) in the Apnea Positive Pressure Long-term Efficacy Study (APPLES), assessed at baseline before randomization to either continuous positive airway pressure (CPAP) or sham CPAP.
  
  
  METHODS
  Sleep and respiratory indices obtained by laboratory polysomnography and several measures of neurocognitive performance.
  
  
  RESULTS
  Weak correlations were found for both the apnea hypopnea index (AHI) and several indices of oxygen desaturation and neurocognitive performance in unadjusted analyses. After adjustment for level of education, ethnicity, and gender, there was no association between the AHI and neurocognitive performance. However, severity of oxygen desaturation was weakly associated with worse neurocognitive performance on some measures of intelligence, attention, and processing speed.
  
  
  CONCLUSIONS
  The impact of OSA on neurocognitive performance is small for many individuals with this condition and is most related to the severity of hypoxemia.
authors.affiliation: Arizona Respiratory Center, University of Arizona, Tucson, AZ, USA. squan@arc.arizona.edu
authors.forename: Stuart F
authors.initials: SF
authors.lastname: Quan
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Chan
authors.forename: William C
authors.initials: WC
authors.lastname: Dement
authors.forename: Alan
authors.initials: A
authors.lastname: Gevins
authors.forename: James L
authors.initials: JL
authors.lastname: Goodwin
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Gottlieb
authors.forename: Sylvan
authors.initials: S
authors.lastname: Green
authors.forename: Christian
authors.initials: C
authors.lastname: Guilleminault
authors.forename: Max
authors.initials: M
authors.lastname: Hirshkowitz
authors.forename: Pamela R
authors.initials: PR
authors.lastname: Hyde
authors.forename: Gary G
authors.initials: GG
authors.lastname: Kay
authors.forename: Eileen B
authors.initials: EB
authors.lastname: Leary
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Nichols
authors.forename: Paula K
authors.initials: PK
authors.lastname: Schweitzer
authors.forename: Richard D
authors.initials: RD
authors.lastname: Simon
authors.forename: James K
authors.initials: JK
authors.lastname: Walsh
authors.forename: Clete A
authors.initials: CA
authors.lastname: Kushida
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D008297:Male; D009483:Neuropsychological Tests; D017286:Polysomnography; D011597:Psychomotor Performance / Q000502:physiology; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D014888:Wechsler Scales