title: Obstructive sleep apnea exaggerates cognitive dysfunction in stroke patients.
abstract: Obstructive sleep apnea (OSA) is very common in stroke survivors. It potentially worsens the cognitive dysfunction and inhibits their functional recovery. However, whether OSA independently damages the cognitive function in stroke patients is unclear. A simple method for evaluating OSA-induced cognitive impairment is also missing.
  
  
  
  Forty-four stroke patients six weeks after onset and 24 non-stroke patients with snoring were recruited for the polysomnographic study of OSA and sleep architecture. Their cognitive status was evaluated with a validated Chinese version of Cambridge Prospective Memory Test. The relationship between memory deficits and respiratory, sleeping, and dementia-related clinical variables were analyzed with correlation and multiple linear regression tests.
  
  
  
  OSA significantly and independently damaged time- and event-based prospective memory in stroke patients, although it had less power than the stroke itself. The impairment of prospective memory was correlated with increased apnea-hypopnea index, decreased minimal and mean levels of peripheral oxygen saturation, and disrupted sleeping continuity (reduced sleep efficiency and increased microarousal index). The further regression analysis identified minimal levels of peripheral oxygen saturation and sleep efficiency to be the two most important predictors for the decreased time-based prospective memory in stroke patients.
  
  
  
  OSA independently contributes to the cognitive dysfunction in stroke patients, potentially through OSA-caused hypoxemia and sleeping discontinuity. The prospective memory test is a simple but sensitive method to detect OSA-induced cognitive impairment in stroke patients. Proper therapies of OSA might improve the cognitive function and increase the life quality of stroke patients.
authors.affiliation: Department of Neurology, The Kunshan Affiliated Hospital of Jiangsu University, 215300 Kunshan, China; Department of Neurology, The First People's Hospital of Kunshan, 215300 Kunshan, China. Electronic address: 2573560757@qq.com.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Neurology, The Kunshan Affiliated Hospital of Jiangsu University, 215300 Kunshan, China; Department of Neurology, The First People's Hospital of Kunshan, 215300 Kunshan, China.
authors.forename: Wanhua
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Respiratory Medicine, The Kunshan Affiliated Hospital of Jiangsu University, 215300 Kunshan, China.
authors.forename: Sijie
authors.initials: S
authors.lastname: Cai
authors.affiliation: Department of Respiratory Medicine, The Kunshan Affiliated Hospital of Jiangsu University, 215300 Kunshan, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Sheng
authors.affiliation: Department of Rehabilitation Medicine, The Kunshan Affiliated Hospital of Jiangsu University, 215300 Kunshan, China.
authors.forename: Shenggui
authors.initials: S
authors.lastname: Pan
authors.affiliation: Department of Neurology, The Kunshan Affiliated Hospital of Jiangsu University, 215300 Kunshan, China; Department of Neurology, The First People's Hospital of Kunshan, 215300 Kunshan, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Shen
authors.affiliation: Department of Neurology, The Kunshan Affiliated Hospital of Jiangsu University, 215300 Kunshan, China; Department of Neurology, The First People's Hospital of Kunshan, 215300 Kunshan, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Tang
authors.affiliation: Department of Neurology, Saarland University, 66421 Homburg, Germany.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D003072:Cognition Disorders / Q000150:complications* / Q000209:etiology / Q000503:physiopathology; D060825:Cognitive Dysfunction / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000150:complications; D008297:Male; D008569:Memory Disorders / Q000150:complications / Q000503:physiopathology; D061212:Memory, Episodic; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism; D017286:Polysomnography / Q000295:instrumentation* / Q000379:methods; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D012890:Sleep / Q000502:physiology; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D020921:Sleep Arousal Disorders / Q000175:diagnosis / Q000503:physiopathology; D012913:Snoring / Q000150:complications; D020521:Stroke / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology
chemical_list: D010100:Oxygen
keywords: Cognition; Obstructive sleep apnea; Prospective memory; Sleep and stroke