Obstructive sleep apnea and 15-year cognitive decline: The atherosclerosis risk in communities (ARIC) study

Pamela L. Lutsey, Lindsay G S Bengtson, Naresh M Punjabi, Eyal Shahar, Thomas H. Mosley, Rebecca F Gottesman, Lisa M. Wruck, Richard F. MacLehose, Alvaro Alonso

Research output: Contribution to journalArticle

Abstract

Study Objectives: Prospective data evaluating abnormal sleep quality and quantity with cognitive decline are limited because most studies used subjective data and/or had short follow-up. We hypothesized that, over 15 y of follow-up, participants with objectively measured obstructive sleep apnea (OSA) and other indices of poor sleep quantity and quality would experience greater decline in cognitive functioning than participants with normal sleep patterns. Methods: ARIC participants (n = 966; mean age 61 y, 55% women) with in-home polysomnography (1996-1998) and repeated cognitive testing were followed for 15 y. Three cognitive tests (Delayed Word Recall, Word Fluency, and Digit Symbol Substitution) were administered at two time points (1996-1998 and 2011-2013). Ten additional cognitive tests were administered at the 2011-2013 neurocognitive examination. OSA was modeled using established clinical OSA severity categories. Multivariable linear regression was used to explore associations of OSA and other sleep indices with change in cognitive tests between the two assessments. Results: A median of 14.9 y (max: 17.3) passed between the two cognitive assessments. OSA category and additional indices of sleep (other measures of hypoxemia and disordered breathing, sleep fragmentation, sleep duration) were not associated with change in any cognitive test. Analyses of OSA severity categories and 10 cognitive tests administered only in 2011-2013 also showed little evidence of an association. Conclusions: Overall, abnormal sleep quality and quantity at midlife was not related to cognitive decline and later-life cognition. The effect of adverse sleep quality and quantity on cognitive decline among the elderly remains to be determined.

Original languageEnglish (US)
Pages (from-to)309-316
Number of pages8
JournalSleep
Volume39
Issue number2
DOIs
StatePublished - Feb 1 2016

Fingerprint

Obstructive Sleep Apnea
Atherosclerosis
Sleep
Sleep Deprivation
Cognitive Dysfunction
Polysomnography
Cognition
Linear Models
Respiration
Prospective Studies

Keywords

  • Atherosclerosis risk in communities (ARIC) study
  • Cognitive decline
  • Epidemiology
  • Obstructive sleep apnea

ASJC Scopus subject areas

  • Physiology (medical)
  • Clinical Neurology

Cite this

Obstructive sleep apnea and 15-year cognitive decline : The atherosclerosis risk in communities (ARIC) study. / Lutsey, Pamela L.; Bengtson, Lindsay G S; Punjabi, Naresh M; Shahar, Eyal; Mosley, Thomas H.; Gottesman, Rebecca F; Wruck, Lisa M.; MacLehose, Richard F.; Alonso, Alvaro.

In: Sleep, Vol. 39, No. 2, 01.02.2016, p. 309-316.

Research output: Contribution to journalArticle

Lutsey, PL, Bengtson, LGS, Punjabi, NM, Shahar, E, Mosley, TH, Gottesman, RF, Wruck, LM, MacLehose, RF & Alonso, A 2016, 'Obstructive sleep apnea and 15-year cognitive decline: The atherosclerosis risk in communities (ARIC) study', Sleep, vol. 39, no. 2, pp. 309-316. https://doi.org/10.5665/sleep.5434
Lutsey, Pamela L. ; Bengtson, Lindsay G S ; Punjabi, Naresh M ; Shahar, Eyal ; Mosley, Thomas H. ; Gottesman, Rebecca F ; Wruck, Lisa M. ; MacLehose, Richard F. ; Alonso, Alvaro. / Obstructive sleep apnea and 15-year cognitive decline : The atherosclerosis risk in communities (ARIC) study. In: Sleep. 2016 ; Vol. 39, No. 2. pp. 309-316.
@article{44153001ace344c8968693ceed6009f5,
title = "Obstructive sleep apnea and 15-year cognitive decline: The atherosclerosis risk in communities (ARIC) study",
abstract = "Study Objectives: Prospective data evaluating abnormal sleep quality and quantity with cognitive decline are limited because most studies used subjective data and/or had short follow-up. We hypothesized that, over 15 y of follow-up, participants with objectively measured obstructive sleep apnea (OSA) and other indices of poor sleep quantity and quality would experience greater decline in cognitive functioning than participants with normal sleep patterns. Methods: ARIC participants (n = 966; mean age 61 y, 55{\%} women) with in-home polysomnography (1996-1998) and repeated cognitive testing were followed for 15 y. Three cognitive tests (Delayed Word Recall, Word Fluency, and Digit Symbol Substitution) were administered at two time points (1996-1998 and 2011-2013). Ten additional cognitive tests were administered at the 2011-2013 neurocognitive examination. OSA was modeled using established clinical OSA severity categories. Multivariable linear regression was used to explore associations of OSA and other sleep indices with change in cognitive tests between the two assessments. Results: A median of 14.9 y (max: 17.3) passed between the two cognitive assessments. OSA category and additional indices of sleep (other measures of hypoxemia and disordered breathing, sleep fragmentation, sleep duration) were not associated with change in any cognitive test. Analyses of OSA severity categories and 10 cognitive tests administered only in 2011-2013 also showed little evidence of an association. Conclusions: Overall, abnormal sleep quality and quantity at midlife was not related to cognitive decline and later-life cognition. The effect of adverse sleep quality and quantity on cognitive decline among the elderly remains to be determined.",
keywords = "Atherosclerosis risk in communities (ARIC) study, Cognitive decline, Epidemiology, Obstructive sleep apnea",
author = "Lutsey, {Pamela L.} and Bengtson, {Lindsay G S} and Punjabi, {Naresh M} and Eyal Shahar and Mosley, {Thomas H.} and Gottesman, {Rebecca F} and Wruck, {Lisa M.} and MacLehose, {Richard F.} and Alvaro Alonso",
year = "2016",
month = "2",
day = "1",
doi = "10.5665/sleep.5434",
language = "English (US)",
volume = "39",
pages = "309--316",
journal = "Sleep",
issn = "0161-8105",
publisher = "American Academy of Sleep Medicine",
number = "2",

}

TY - JOUR

T1 - Obstructive sleep apnea and 15-year cognitive decline

T2 - The atherosclerosis risk in communities (ARIC) study

AU - Lutsey, Pamela L.

AU - Bengtson, Lindsay G S

AU - Punjabi, Naresh M

AU - Shahar, Eyal

AU - Mosley, Thomas H.

AU - Gottesman, Rebecca F

AU - Wruck, Lisa M.

AU - MacLehose, Richard F.

AU - Alonso, Alvaro

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Study Objectives: Prospective data evaluating abnormal sleep quality and quantity with cognitive decline are limited because most studies used subjective data and/or had short follow-up. We hypothesized that, over 15 y of follow-up, participants with objectively measured obstructive sleep apnea (OSA) and other indices of poor sleep quantity and quality would experience greater decline in cognitive functioning than participants with normal sleep patterns. Methods: ARIC participants (n = 966; mean age 61 y, 55% women) with in-home polysomnography (1996-1998) and repeated cognitive testing were followed for 15 y. Three cognitive tests (Delayed Word Recall, Word Fluency, and Digit Symbol Substitution) were administered at two time points (1996-1998 and 2011-2013). Ten additional cognitive tests were administered at the 2011-2013 neurocognitive examination. OSA was modeled using established clinical OSA severity categories. Multivariable linear regression was used to explore associations of OSA and other sleep indices with change in cognitive tests between the two assessments. Results: A median of 14.9 y (max: 17.3) passed between the two cognitive assessments. OSA category and additional indices of sleep (other measures of hypoxemia and disordered breathing, sleep fragmentation, sleep duration) were not associated with change in any cognitive test. Analyses of OSA severity categories and 10 cognitive tests administered only in 2011-2013 also showed little evidence of an association. Conclusions: Overall, abnormal sleep quality and quantity at midlife was not related to cognitive decline and later-life cognition. The effect of adverse sleep quality and quantity on cognitive decline among the elderly remains to be determined.

AB - Study Objectives: Prospective data evaluating abnormal sleep quality and quantity with cognitive decline are limited because most studies used subjective data and/or had short follow-up. We hypothesized that, over 15 y of follow-up, participants with objectively measured obstructive sleep apnea (OSA) and other indices of poor sleep quantity and quality would experience greater decline in cognitive functioning than participants with normal sleep patterns. Methods: ARIC participants (n = 966; mean age 61 y, 55% women) with in-home polysomnography (1996-1998) and repeated cognitive testing were followed for 15 y. Three cognitive tests (Delayed Word Recall, Word Fluency, and Digit Symbol Substitution) were administered at two time points (1996-1998 and 2011-2013). Ten additional cognitive tests were administered at the 2011-2013 neurocognitive examination. OSA was modeled using established clinical OSA severity categories. Multivariable linear regression was used to explore associations of OSA and other sleep indices with change in cognitive tests between the two assessments. Results: A median of 14.9 y (max: 17.3) passed between the two cognitive assessments. OSA category and additional indices of sleep (other measures of hypoxemia and disordered breathing, sleep fragmentation, sleep duration) were not associated with change in any cognitive test. Analyses of OSA severity categories and 10 cognitive tests administered only in 2011-2013 also showed little evidence of an association. Conclusions: Overall, abnormal sleep quality and quantity at midlife was not related to cognitive decline and later-life cognition. The effect of adverse sleep quality and quantity on cognitive decline among the elderly remains to be determined.

KW - Atherosclerosis risk in communities (ARIC) study

KW - Cognitive decline

KW - Epidemiology

KW - Obstructive sleep apnea

UR - http://www.scopus.com/inward/record.url?scp=84957066769&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84957066769&partnerID=8YFLogxK

U2 - 10.5665/sleep.5434

DO - 10.5665/sleep.5434

M3 - Article

C2 - 26446113

AN - SCOPUS:84957066769

VL - 39

SP - 309

EP - 316

JO - Sleep

JF - Sleep

SN - 0161-8105

IS - 2

ER -