Association of Mild Obstructive Sleep Apnea With Cognitive Performance, Excessive Daytime Sleepiness, and Quality of Life in the General Population: The Korean Genome and Epidemiology Study (KoGES).
Research points to impaired cognitive performance in sleep clinic patients with obstructive sleep apnea (OSA). However, inconsistent findings from various epidemiologic studies make this relationship less generalizable. The current study investigated the association between OSA and functional outcome measures, such as cognition, daytime sleepiness, and quality of life, in a Korean general population sample.



A total of 1492 participants from the Korean Genome and Epidemiology Study (KoGES) were included in the analyses. The presence of OSA measured by overnight polysomnography (PSG) was defined by apnea-hypopnea index (AHI) >5. Cognitive performance was determined with scores from a comprehensive neuropsychological battery. Excessive daytime sleepiness and quality of life were additionally measured through subjective reports.



After adjusting for various demographic and medical characteristics, OSA was independently associated with lower performance in the Digit Symbol Test (52.73 ± 17.08 vs. 58.72 ± 18.03, OSA vs. not, p = .02). Hypoxia measures were not related to cognitive performance. OSA was associated with higher odds of displaying excessive daytime sleepiness (odds ratio = 1.72, 95% CI: 1.05-2.80), but there was no significant relationship between OSA and quality of life.



Cognition was unexpectedly unaffected overall. However, OSA was associated with impairment in a multidomain test that taps skills generally associated with frontal lobe function. The results suggest that research on protective and adaptive brain mechanisms to OSA stress can provide unique insights into the brain-sleep interface. As the study runs longitudinally, it will enable future studies on the impact of OSA on cognitive decline.
Department of Psychological and Brain Sciences, Boston University.|Institute of Human Genomic Study, Korea University Ansan Hospital.|Framingham Heart Study, Boston University School of Medicine.
Hyun
H
Kim
Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center.
Robert J
RJ
Thomas
Department of Neurology, Seoul National University Bundang Hospital.
Chang-Ho
CH
Yun
Framingham Heart Study, Boston University School of Medicine.
Rhoda
R
Au
Institute of Human Genomic Study, Korea University Ansan Hospital.
Seung Ku
SK
Lee
Institute of Human Genomic Study, Korea University Ansan Hospital.
Sunghee
S
Lee
Institute of Human Genomic Study, Korea University Ansan Hospital.|Department of Respiratory Internal Medicine, Korea University Ansan Hospital.
Chol
C
Shin
D003071:Cognition / Q000502:physiology*; D005260:Female; D005625:Frontal Lobe / Q000502:physiology; D015894:Genome, Human; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017286:Polysomnography; D011788:Quality of Life; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology*; D012894:Sleep Stages / Q000502:physiology*
cognition; daytime sleepiness; general population.; obstructive sleep apnea