Withstanding the obstructive sleep apnea syndrome at the expense of arousal instability, altered cerebral autoregulation and neurocognitive decline.
The present review attempts to put together the available evidence and potential research paradigms at the interface of obstructive sleep apnea syndrome (OSAS), sleep micro- and macrostructure, cerebral vasoreactivity and cognitive neuroscience. Besides the significant health-related consequences of OSAS including hypertension, increased risk of cardio- and cerebrovascular events, notable neurocognitive lapses and excessive daytime somnolence are considered as potential burdens. The intermittent nocturnal hypoxia and hypercapnia which occur in OSAS are known to affect cerebral circulation and result in brain hypoperfusion. Arousal instability is then resulted from altered cyclic alternating patterns (CAPs) reflected in sleep EEG. In chronic state, some pathological loss of gray matter may be resulted from obstructive sleep apnea. This is proposed to be related to an upregulated proinflammatory state which may potentially result in apoptotic cell loss in the brain. On this basis, a pragmatic framework of the possible neural mechanisms which underpin obstructive sleep apnea-related neurocognitive decline has been discussed in this review. In addition, the impact of OSAS on cerebral autoregulation and sleep microstructure has been articulated.
Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran.|Sleep Disorders Laboratory, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran.|Brain and Cognition Study Group (BCSG), Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran.
Mohammad
M
Torabi-Nami
Sleep Disorders Laboratory, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran.|Division of Pulmonology, Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran.
Samrad
S
Mehrabi
Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran.|Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran.
Afshin
A
Borhani-Haghighi
Sleep Disorders Unit, American Hospital, Koç Foundation, Istanbul 34365, Turkey.
Sabri
S
Derman
D001289:Attention Deficit Disorder with Hyperactivity / Q000209:etiology*; D002540:Cerebral Cortex / Q000503:physiopathology*; D003072:Cognition Disorders / Q000209:etiology*; D006801:Humans; D020181:Sleep Apnea, Obstructive / Q000150:complications*
Obstructive sleep apnea; cerebral autoregulation; cyclic alternating patterns; neurocognitive performance; sleep microstructure