title: Obstructive Sleep Apnea and Cognition in Parkinson's disease.
abstract: Obstructive sleep apnea (OSA) is very common in Parkinson's disease (PD). OSA is known to affect patients' cognition. The present study assessed whether PD patients with OSA (PD + OSA) score lower on cognitive measures than those without OSA (PD - OSA). In addition, this study evaluated whether treating the OSA with continuous positive airway pressure (CPAP) in PD + OSA patients results in an improved cognitive functioning.
  
  
  
  Eighty-six patients with PD underwent an overnight polysomnography screen for OSA and were administered the Mini-Mental Status Exam (MMSE) and the Montreal Cognitive Assessment (MoCA). This resulted in 38 patients with PD + OSA who were randomly assigned to receive either therapeutic CPAP for 6 weeks (n = 19) or placebo CPAP for three weeks followed by therapeutic CPAP for three weeks (n = 19). Intervention participants completed a neurocognitive battery at baseline and 3- and 6-week time-points.
  
  
  
  Patients with PD + OSA scored significantly lower than PD - OSA on the MMSE and MoCA after controlling for age, education, and PD severity. OSA was a significant predictor of cognition (MMSE p <0.01; MoCA p = 0.028).There were no significant changes between groups in cognition when comparing three weeks of therapeutic CPAP with 3 weeks of placebo CPAP. Comparisons between pre-treatment and 3-week post-therapeutic CPAP for the entire sample also revealed no significant changes on overall neuropsychological (NP) scores.
  
  
  
  Findings suggest that PD patients with OSA show worse cognitive functioning on cognitive screening measures than those without OSA. However, OSA treatment after three or six weeks of CPAP may not result in overall cognitive improvement in patients with PD.
authors.affiliation: Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA.
authors.forename: Alexandrea L
authors.initials: AL
authors.lastname: Harmell
authors.affiliation: Department of Anesthesiology, University of Utah, Salt Lake City, UT, USA.
authors.forename: Ariel B
authors.initials: AB
authors.lastname: Neikrug
authors.affiliation: Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA; Stein Institute for Research on Aging, CA, USA; Veterans Administration Healthcare System, San Diego, CA, USA.
authors.forename: Barton W
authors.initials: BW
authors.lastname: Palmer
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, USA; Stein Institute for Research on Aging, CA, USA.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Avanzino
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, USA.
authors.forename: Lianqi
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, USA; Stein Institute for Research on Aging, CA, USA; Veterans Administration Healthcare System, San Diego, CA, USA.
authors.forename: Jeanne E
authors.initials: JE
authors.lastname: Maglione
authors.affiliation: Department of Family and Preventative Medicine, University of California, San Diego, CA, USA.
authors.forename: Loki
authors.initials: L
authors.lastname: Natarajan
authors.affiliation: Department of Neurosciences, University of California, San Diego, CA, USA.
authors.forename: Jody
authors.initials: J
authors.lastname: Corey-Bloom
authors.affiliation: Veterans Administration Healthcare System, San Diego, CA, USA; Department of Medicine, University of California, San Diego, CA, USA.
authors.forename: Jose S
authors.initials: JS
authors.lastname: Loredo
authors.affiliation: Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA; Stein Institute for Research on Aging, CA, USA; Department of Medicine, University of California, San Diego, CA, USA. Electronic address: sancoliisrael@ucsd.edu.
authors.forename: Sonia
authors.initials: S
authors.lastname: Ancoli-Israel
mesh_terms: D000368:Aged; D003071:Cognition; D045422:Continuous Positive Airway Pressure / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010300:Parkinson Disease / Q000150:complications*; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome
keywords: Cognition; Continuous positive airway pressure; Intervention; Neuropsychology; Obstructive sleep apnea; Parkinson's disease