title: Impact of medications on cognitive function in obstructive sleep apnea syndrome.
abstract: OBJECTIVE
  Medications can impact cognitive function. Obstructive sleep apnea syndrome (OSAS) is associated with cognitive impairment. There is currently a paucity of data evaluating the impact of medications on sleep architecture and cognition in untreated OSAS. Our objective was to evaluate the impact of obstructive sleep apnea syndrome (OSAS) and medications on cognition by a screening questionnaire called the Mail-In Cognitive Function Screening Instrument (MCFSI).
  
  
  METHODS
  We conducted a retrospective chart review on consecutive adults (age > 18 years) with OSAS seen in Medical University of South Carolina Sleep Clinic between January 1, 2012 and May 8, 2013, for whom the Mail-In Cognitive Function Screening Instrument (MCFSI) score was available and who were not on continuous positive airway pressure (CPAP). The correlation between different medications, sleep study variables, and MCFSI scores was studied.
  
  
  RESULTS
  Univariate analysis revealed that many medications had significant correlations with MCFSI scores, including antidepressants (p = 0.05), antipsychotics (p = 0.01), anxiolytics (p = 0.005), statins (p = 0.077) and narcotics (p = 0.006). The mean percentage of rapid eye movement (REM) sleep (p = 0.04) and Epworth Sleepiness Scale (p = 0.01) were also significantly correlated with MCFSI scores. Multivariate analysis revealed that Epworth Sleepiness Scale and use of antipsychotics, narcotics, and anxiolytics correlated with higher MCFSI scores (worse cognition) and conversely that statin use was associated with improved cognition.
  
  
  CONCLUSIONS
  Medications have a significant impact on cognitive function in OSAS. Thus, medication use should be considered in future studies of cognitive function in patients with OSAS.
authors.affiliation: Pulmonary, Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, CSB Suite 812, Msc 630, Charleston, SC, 29425, USA, lalch@musc.edu.
authors.forename: Chitra
authors.initials: C
authors.lastname: Lal
authors.forename: Nasar
authors.initials: N
authors.lastname: Siddiqi
authors.forename: Suchit
authors.initials: S
authors.lastname: Kumbhare
authors.forename: Charlie
authors.initials: C
authors.lastname: Strange
mesh_terms: D000328:Adult; D000368:Aged; D003072:Cognition Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy*; D004347:Drug Interactions; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D016013:Likelihood Functions; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009483:Neuropsychological Tests; D017286:Polysomnography / Q000187:drug effects*; D011619:Psychotropic Drugs / Q000009:adverse effects* / Q000627:therapeutic use*; D012189:Retrospective Studies; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D013223:Statistics as Topic; D011795:Surveys and Questionnaires
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011619:Psychotropic Drugs