Sleep Apnea Status Linked With White Matter Integrity, Cognition Over Time

Obstructive sleep apnea (OSA) was associated with impaired cognitive performance and white matter integrity over 4 years of follow-up, according to study results published online in JAMA Network Open.

“It is possible that adequate interventions for OSA could better preserve brain health in middle to late adulthood,” wrote study lead author Min-Hee Lee, PhD, Korea University Ansan Hospital, and coauthors.

To investigate longitudinal links between OSA and cognition as well as white matter integrity, researchers performed overnight polysomnography, diffusion tensor imaging, and neuropsychological assessments at2 time points 4 years apart. Participants were a representative sample of middle-aged adults and older adults in Korea.

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Among 1110 participants in the analysis, researchers categorized 458 participants as OSA-free, 72 participants with resolved OSA, 163 participants with incident OSA, and 417 participants with persistent OSA.

According to the findings, incident OSA was associated with altered white matter integrity and with related changes in sustained attention compared with participants who were OSA-free. Researchers reported an average 3.2% drop in Digit Symbol-coding test scores.

Meanwhile, participants with resolved OSA had improved visual recall at follow-up. Scores improved an average 17.5% on the Visual Reproduction-immediate recall test and 33.1% on the Visual Reproduction-delayed recall test. Concordant changes occurred in diffusion parameters at relevant anatomic areas, the study found.

Subgroup analyses showed persistent OSA was linked with altered cerebral white matter integrity and cognition in adults 60 years and older. Additionally, sex was associated with modifying associations of white matter integrity in men and cognitive function in women.

“This cohort study found that OSA was associated with differences in cognitive performance and white matter integrity over time, especially in the older subgroup,” researchers concluded. “These findings could provide potential targets for intervention to preserve brain health.”

Reference

Lee MH, Lee SK, Kim S, et al. Association of obstructive sleep apnea with white matter integrity and cognitive performance over a 4-year period in middle to late adulthood. JAMA Netw Open. Published online July 20, 2022. doi: 10.1001/jamanetworkopen.2022.22999.