title: Impact of obstructive sleep apnea syndrome on cognition in early postmenopausal women.
abstract: OBJECTIVE
  Obstructive sleep apnea syndrome (OSAS) has a higher prevalence in postmenopausal women who are not on hormone replacement therapy (HRT), as compared to premenopausal women. Cognitive impairment (CI) is associated with OSAS and the early postmenopausal state. We hypothesized that compared to postmenopausal women at low risk for OSAS, postmenopausal women at high risk for OSAS would report worse cognitive function.
  
  
  METHODS
  Early postmenopausal women not on HRT between the ages of 45 and 60 years, within 5 years of natural menopause, were enrolled. Participants completed a REDCap survey which collected information on demographics and risk factors, Berlin questionnaire to screen subjects for OSAS risk, and the Mail-In Cognitive Function Screening Instrument (MCFSI) score which was used to assess CI.
  
  
  RESULTS
  Of 381 respondents, 127 were omitted due to missing/duplicate data or not meeting inclusion criteria. One hundred fifty-four women were classified as high risk for OSAS (OSAS+), and 100 were classified as low risk for OSAS (OSAS-). OSAS- women reported lifetime smoking, lifetime drinking, and recreational drug use more often than OSAS+ women, while OSAS+ women reported a depression diagnosis more often. The mean MCFSI score in the OSAS+ group was significantly higher (worse cognition) than in the OSAS- group after controlling for covariates (5.59, 95 % CI 5.08-6.11 vs. 4.29, 95 % CI 3.64-4.93, p < 0.05).
  
  
  CONCLUSIONS
  Early postmenopausal women at high risk for OSAS report more CI than those at low risk for OSAS. Future studies should identify biomarkers of this CI and define the degree of reversibility of CI with OSAS treatment.
authors.affiliation: Pulmonary, Critical Care, and Sleep, 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.affiliation: Department of Neurosciences, Medical University of South Carolina, Charleston, USA.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: DiBartolo
authors.affiliation: Pulmonary, Critical Care, and Sleep, Medical University of South Carolina, 96 Jonathan Lucas Street, CSB Suite 812, Msc 630, Charleston, SC, 29425, USA.
authors.forename: Suchit
authors.initials: S
authors.lastname: Kumbhare
authors.affiliation: Pulmonary, Critical Care, and Sleep, Medical University of South Carolina, 96 Jonathan Lucas Street, CSB Suite 812, Msc 630, Charleston, SC, 29425, USA.
authors.forename: Charlie
authors.initials: C
authors.lastname: Strange
authors.affiliation: Department of Neurosciences, Medical University of South Carolina, Charleston, USA.
authors.forename: Jane E
authors.initials: JE
authors.lastname: Joseph
mesh_terms: D060825:Cognitive Dysfunction / Q000175:diagnosis*; D015331:Cohort Studies; D015897:Comorbidity; D003704:Dementia / Q000175:diagnosis*; D003866:Depressive Disorder / Q000175:diagnosis; D005260:Female; D006801:Humans; D008875:Middle Aged; D009483:Neuropsychological Tests; D017698:Postmenopause; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*
keywords: Berlin questionnaire; Cognitive impairment; Hippocampus; Hypoxemia; Mail-in Cognitive Function Screening Instrument; Obstructive sleep apnea syndrome; Postmenopausal