Am. J. Respir. Crit. Care Med., Volume 156, Number 6, December 1997, 1813-1819

Sleep-disordered Breathing and Neuropsychological Deficits
A Population-based Study

HYON C. KIM, TERRY YOUNG, CHARLES G. MATTHEWS, STEVEN M. WEBER, AUSTIN R. WOODARD, and MARI PALTA

Departments of Preventive Medicine, Medicine, and Neurology, University of Wisconsin-Madison, Madison, Wisconsin

The relationship of sleep-disordered breathing (SDB) to neuropsychological deficits was investigated with cross-sectional data from the Wisconsin Sleep Cohort Study, a population-based study of the natural history of SDB. A sample of 841 employed men and women ages 30 to 60 yr was studied by overnight polysomnography to assess the frequency of apneas and hypopneas per hour of sleep (apnea-hypopnea index, AHI). Prior to overnight polysomnography, the participants were given a battery of neuropsychological tests for functionally important capacities including motor skills, attention, concentration, information processing, and memory. Principal factor analysis of all the neuropsychological test data revealed a psychomotor efficiency and a memory factor. Multiple regression analysis showed a significant negative association between logarithmically transformed AHI (LogAHI) and psychomotor efficiency score independent of age, gender, and educational status (p = 0.017). The relationship was not explained by self-reported sleepiness. No significant relationship was seen between LogAHI and memory score. In assessing the clinical significance of mild SDB, we estimate that an AHI of 15 is equivalent to the decrement in psychomotor efficiency associated with 5 additional yr of age, or to 50% of the decrement associated with hypnosedative use.

This article has been cited by other articles:

				M. Z. Molnar, A. Szentkiralyi, A. Lindner, M. E. Czira, A. Szabo, I. Mucsi, and M. Novak High prevalence of patients with a high risk for obstructive sleep apnoea syndrome after kidney transplantation association with declining renal function Nephrol. Dial. Transplant., September 1, 2007; 22(9): 2686 - 2692. [Abstract] [Full Text] [PDF]

				M. C. Hlavac, P. G. Catcheside, A. Adams, D. J. Eckert, and R. D. McEvoy The effects of hypoxia on load compensation during sustained incremental resistive loading in patients with obstructive sleep apnea J Appl Physiol, July 1, 2007; 103(1): 234 - 239. [Abstract] [Full Text] [PDF]

				J. L. Emancipator, A. Storfer-Isser, H. G. Taylor, C. L. Rosen, H. L. Kirchner, N. L. Johnson, A. M. Zambito, and S. Redline Variation of Cognition and Achievement With Sleep-Disordered Breathing in Full-term and Preterm Children Arch Pediatr Adolesc Med, February 1, 2006; 160(2): 203 - 210. [Abstract] [Full Text] [PDF]

				G. Insalaco, S. Romano, O. Marrone, A. Salvaggio, and G. Bonsignore A New Method of Negative Expiratory Pressure Test Analysis Detecting Upper Airway Flow Limitation To Reveal Obstructive Sleep Apnea Chest, October 1, 2005; 128(4): 2159 - 2165. [Abstract] [Full Text] [PDF]

				M. S. Aloia, M. Stanchina, J. T. Arnedt, A. Malhotra, and R. P. Millman Treatment Adherence and Outcomes in Flexible vs Standard Continuous Positive Airway Pressure Therapy Chest, June 1, 2005; 127(6): 2085 - 2093. [Abstract] [Full Text] [PDF]

				J. G. Breugelmans, D. E. Ford, P. L. Smith, and N. M. Punjabi Differences in Patient and Bed Partner-assessed Quality of Life in Sleep-disordered Breathing Am. J. Respir. Crit. Care Med., September 1, 2004; 170(5): 547 - 552. [Abstract] [Full Text] [PDF]

				I. Gurubhagavatula, G. Maislin, J. E. Nkwuo, and A. I. Pack Occupational Screening for Obstructive Sleep Apnea in Commercial Drivers Am. J. Respir. Crit. Care Med., August 15, 2004; 170(4): 371 - 376. [Abstract] [Full Text] [PDF]

				E. Sforza, J. Haba-Rubio, F. De Bilbao, T. Rochat, and V. Ibanez Performance vigilance task and sleepiness in patients with sleep-disordered breathing Eur. Respir. J., August 1, 2004; 24(2): 279 - 285. [Abstract] [Full Text] [PDF]

				A. S. Jordan, R. D. McEvoy, J. K. Edwards, K. Schory, C.-K. Yang, P. G. Catcheside, R. B. Fogel, A. Malhotra, and D. P. White The influence of gender and upper airway resistance on the ventilatory response to arousal in obstructive sleep apnoea in humans J. Physiol., August 1, 2004; 558(3): 993 - 1004. [Abstract] [Full Text] [PDF]

				H M Engleman and N J Douglas Sleep {middle dot} 4: Sleepiness, cognitive function, and quality of life in obstructive sleep apnoea/hypopnoea syndrome Thorax, July 1, 2004; 59(7): 618 - 622. [Abstract] [Full Text] [PDF]

				L.-j. W. Suen Jr., D. L. Morris, and G. J. McDougall Memory Functions of Taiwanese American Older Adults1 West J Nurs Res, March 1, 2004; 26(2): 222 - 241. [Abstract] [PDF]

				N. Pelletier-Fleury, N. Meslier, F. Gagnadoux, C. Person, D. Rakotonanahary, H. Ouksel, B. Fleury, and J-L. Racineux Economic arguments for the immediate management of moderate-to-severe obstructive sleep apnoea syndrome Eur. Respir. J., January 1, 2004; 23(1): 53 - 60. [Abstract] [Full Text] [PDF]

				J. G. Sotos Taft and Pickwick: Sleep Apnea in the White House Chest, September 1, 2003; 124(3): 1133 - 1142. [Abstract] [Full Text] [PDF]

				T. Young, P. E. Peppard, and D. J. Gottlieb Epidemiology of Obstructive Sleep Apnea: A Population Health Perspective Am. J. Respir. Crit. Care Med., May 1, 2002; 165(9): 1217 - 1239. [Abstract] [Full Text] [PDF]

				M Kamba, Y Inoue, S Higami, Y Suto, T Ogawa, and W Chen Cerebral metabolic impairment in patients with obstructive sleep apnoea: an independent association of obstructive sleep apnoea with white matter change J. Neurol. Neurosurg. Psychiatry, September 1, 2001; 71(3): 334 - 339. [Abstract] [Full Text] [PDF]

				N. ADAMS, M. STRAUSS, M. SCHLUCHTER, and S. REDLINE Relation of Measures of Sleep-Disordered Breathing to Neuropsychological Functioning Am. J. Respir. Crit. Care Med., June 1, 2001; 163(7): 1626 - 1631. [Abstract] [Full Text] [PDF]

				K. G. HENKE, J. J. GRADY, and S. T. KUNA Effect of Nasal Continuous Positive Airway Pressure on Neuropsychological Function in Sleep Apnea-Hypopnea Syndrome . A Randomized, Placebo-controlled Trial Am. J. Respir. Crit. Care Med., March 15, 2001; 163(4): 911 - 917. [Abstract] [Full Text]

				P. E. Peppard, T. Young, M. Palta, J. Dempsey, and J. Skatrud Longitudinal Study of Moderate Weight Change and Sleep-Disordered Breathing JAMA, December 20, 2000; 284(23): 3015 - 3021. [Abstract] [Full Text] [PDF]

				R. D. Chervin Sleepiness, Fatigue, Tiredness, and Lack of Energy in Obstructive Sleep Apnea Chest, August 1, 2000; 118(2): 372 - 379. [Abstract] [Full Text] [PDF]

				H. M. ENGLEMAN, R. N. KINGSHOTT, P. K. WRAITH, T. W. MACKAY, I. J. DEARY, and N. J. DOUGLAS Randomized Placebo-controlled Crossover Trial of Continuous Positive Airway Pressure for Mild Sleep Apnea/Hypopnea Syndrome Am. J. Respir. Crit. Care Med., February 1, 1999; 159(2): 461 - 467. [Abstract] [Full Text]