Biomarkers of cognitive impairment in obstructive sleep apnea

Zhijun Wang , Zhiqiang Li , Guo Pei , Mengjie Wang , Yufei Xie , Xin Wang , Jing Wang , Rui Chen

Sleep Research ›› 2025, Vol. 2 ›› Issue (1) : 23 -41.

PDF
Sleep Research ›› 2025, Vol. 2 ›› Issue (1) : 23 -41. DOI: 10.1002/slp2.70000
REVIEW

Biomarkers of cognitive impairment in obstructive sleep apnea

Author information +
History +
PDF

Abstract

Mild cognitive impairment (MCI) associated with obstructive sleep apnea (OSA) has garnered widespread attention. The mechanisms underlying MCI in patients with OSA are currently believed to be the combined effects of nocturnal intermittent hypoxia, hypercapnia, and sleep fragmentation, all of which can impact cerebral blood flow, synaptic function, and the integrity of the blood–brain barrier. However, the neural mechanisms contributing to MCI in patients with OSA remain incompletely understood. Recently, an increasing number of studies have focused on the identifying biomarkers for cognitive impairment in patients with OSA. In this review, we summarize the biomarkers related to cognitive impairment in patients with OSA including those found in body fluids, magnetic resonance imaging, and electroencephalography as well as the impact of continuous positive airway pressure treatment on them. This review aims to provide valuable insights for future research on the mechanisms of cognitive impairment in patients with OSA and potential therapeutic strategies.

Keywords

biomarker / body fluids / cognitive impairment / continuous positive airway pressure / electroencephalography / magnetic resonance imaging / obstructive sleep apnea

Cite this article

Download citation ▾
Zhijun Wang, Zhiqiang Li, Guo Pei, Mengjie Wang, Yufei Xie, Xin Wang, Jing Wang, Rui Chen. Biomarkers of cognitive impairment in obstructive sleep apnea. Sleep Research, 2025, 2(1): 23-41 DOI:10.1002/slp2.70000

登录浏览全文

4963

注册一个新账户 忘记密码

References

[1]

Benjafield AV, Ayas NT, Eastwood PR, et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med. 2019; 7(8): 687-698. https://doi.org/10.1016/S2213-2600(19)30198-5

[2]

Zasadzinska-Stempniak K, Zajaczkiewicz H, Kukwa A. Prevalence of obstructive sleep apnea in the young adult population: a systematic review. J Clin Med. 2024; 13(5):1386. https://doi.org/10.3390/jcm13051386

[3]

Redline S, Azarbarzin A, Peker Y. Obstructive sleep apnoea heterogeneity and cardiovascular disease. Nat Rev Cardiol. 2023; 20(8): 560-573. https://doi.org/10.1038/s41569-023-00846-6

[4]

Liu PY, Reddy RT. Sleep, testosterone and cortisol balance, and ageing men. Rev Endocr Metab Disord. 2022; 23(6): 1323-1339. https://doi.org/10.1007/s11154-022-09755-4

[5]

Drager LF, Togeiro SM, Polotsky VY, Lorenzi-Filho G. Obstructive sleep apnea: a cardiometabolic risk in obesity and the metabolic syndrome. J Am Coll Cardiol. 2013; 62(7): 569-576. https://doi.org/10.1016/j.jacc.2013.05.045

[6]

Baillieul S, Dekkers M, Brill AK, et al. Sleep apnoea and ischaemic stroke: current knowledge and future directions. Lancet Neurol. 2022; 21(1): 78-88. https://doi.org/10.1016/S1474-4422(21)00321-5

[7]

Ferreira PM, Carvalho I, Redondo M, van Zeller M, Drummond M. The role of obstructive sleep apnea and nocturnal hypoxia as predictors of mortality in cancer patients. Sleep Med. 2024; 121: 258-265. https://doi.org/10.1016/j.sleep.2024.07.017

[8]

Bubu OM, Andrade AG, Umasabor-Bubu OQ, et al. Obstructive sleep apnea, cognition and Alzheimer's disease: a systematic review integrating three decades of multidisciplinary research. Sleep Med Rev. 2020; 50:101250. https://doi.org/10.1016/j.smrv.2019.101250

[9]

Liguori C, Maestri M, Spanetta M, et al. Sleep-disordered breathing and the risk of Alzheimer's disease. Sleep Med Rev. 2021; 55:101375. https://doi.org/10.1016/j.smrv.2020.101375

[10]

Bucks RS, Olaithe M, Rosenzweig I, Morrell MJ. Reviewing the relationship between OSA and cognition: where do we go from here? Respirology. 2017; 22(7): 1253-1261. https://doi.org/10.1111/resp.13140

[11]

Vanek J, Prasko J, Genzor S, et al. Obstructive sleep apnea, depression and cognitive impairment. Sleep Med. 2020; 72: 50-58. https://doi.org/10.1016/j.sleep.2020.03.017

[12]

Beaudin AE, Raneri JK, Ayas NT, et al. Cognitive function in a sleep clinic cohort of patients with obstructive sleep apnea. Ann Am Thorac Soc. 2021; 18(5): 865-875. https://doi.org/10.1513/AnnalsATS.202004-313OC

[13]

Sgaria VP, Cielo CA, Bortagarai FM, et al. CPAP Treatment Improves Quality of Life and Self-Perception of Voice Impairment in Oatients with OSA. J Voice; 2024. https://doi.org/10.1016/j.jvoice.2024.02.004

[14]

de Batlle J, Gracia-Lavedan E, Escarrabill J, et al. Effect of CPAP treatment on cardiovascular outcomes. Arch Bronconeumol. 2024; 60(10): 627-633. https://doi.org/10.1016/j.arbres.2024.05.029

[15]

Sun L, Chang YF, Wang YF, et al. Effect of continuous positive airway pressure on blood pressure in patients with resistant hypertension and obstructive sleep apnea: an updated meta-analysis. Curr Hypertens Rep. 2024; 26(5): 201-211. https://doi.org/10.1007/s11906-024-01294-4

[16]

Makhdom EA, Maher A, Ottridge R, et al. The impact of obstructive sleep apnea treatment on microvascular complications in patients with type 2 diabetes: a feasibility randomized controlled trial. J Clin Sleep Med. 2024; 20(6): 947-957. https://doi.org/10.5664/jcsm.11020

[17]

Liu X, Wei Z, Ting L, et al. Microstructural changes in the cerebral white matter after 12 months of CPAP treatment for moderate to severe obstructive sleep apnoea: a TBSS study. Nat Sci Sleep. 2024; 16: 531-542. https://doi.org/10.2147/NSS.S460919

[18]

Li M, Sun Z, Sun H, et al. Paroxysmal slow wave events are associated with cognitive impairment in patients with obstructive sleep apnea. Alzheimers Res Ther. 2022; 14(1): 200. https://doi.org/10.1186/s13195-022-01153-x

[19]

Labarca G, Gower J, Lamperti L, Dreyse J, Jorquera J. Chronic intermittent hypoxia in obstructive sleep apnea: a narrative review from pathophysiological pathways to a precision clinical approach. Sleep Breath. 2020; 24(2): 751-760. https://doi.org/10.1007/s11325-019-01967-4

[20]

Orru G, Storari M, Scano A, et al. Obstructive sleep apnea, oxidative stress, inflammation and endothelial dysfunction-an overview of predictive laboratory biomarkers. Eur Rev Med Pharmacol Sci. 2020; 24(12): 6939-6948. https://doi.org/10.26355/eurrev_202006_21685

[21]

Zlokovic BV. The blood-brain barrier in health and chronic neurodegenerative disorders. Neuron. 2008; 57(2): 178-201. https://doi.org/10.1016/j.neuron.2008.01.003

[22]

Stranahan AM, Hao S, Dey A, Yu X, Baban B. Blood-brain barrier breakdown promotes macrophage infiltration and cognitive impairment in leptin receptor-deficient mice. J Cereb Blood Flow Metab. 2016; 36(12): 2108-2121. https://doi.org/10.1177/0271678X16642233

[23]

Aloia MS, Arnedt JT, Davis JD, Riggs RL, Byrd D. Neuropsychological sequelae of obstructive sleep apnea-hypopnea syndrome: a critical review. J Int Neuropsychol Soc. 2004; 10(5): 772-785. https://doi.org/10.1017/S1355617704105134

[24]

Liu X, Ding H, Li X, et al. Hypercapnia exacerbates the blood-brain barrier disruption via promoting HIF-1a nuclear translocation in the astrocytes of the hippocampus: implication in further cognitive impairment in hypoxemic adult rats. Neurochem Res. 2020; 45(7): 1674-1689. https://doi.org/10.1007/s11064-020-03038-7

[25]

Hu Y, Mai L, Luo J, et al. Peripheral blood oxidative stress markers for obstructive sleep apnea-a meta-analysis. Sleep Breath. 2022; 26(4): 2045-2057. https://doi.org/10.1007/s11325-021-02557-z

[26]

Pan Q, Li H, Gan X, Chen X, Liu X, Li J. Correlation between cognitive impairment and serum markers in patients with obstructive sleep apnea-hypopnea syndrome. Sleep Breath. 2024; 28(2): 683-690. https://doi.org/10.1007/s11325-023-02942-w

[27]

Yeo B, Koh JH, Ng A, et al. The association of obstructive sleep apnea with blood and cerebrospinal fluid biomarkers of Alzheimer's dementia - a systematic review and meta-analysis. Sleep Med Rev. 2023; 70:101790. https://doi.org/10.1016/j.smrv.2023.101790

[28]

Ju J, Chen R, Li T, et al. [Modulation of hippocampal synaptic transmission in a mouse model of chronic intermittent hypoxia: implications for neurocognitive impairments. Zhonghua Yi Xue Za Zhi. 2016; 96(8): 610-614. https://doi.org/10.3760/cma.j.issn.0376-2491.2016.08.006

[29]

Macey PM, Henderson LA, Macey KE, et al. Brain morphology associated with obstructive sleep apnea. Am J Respir Crit Care Med. 2002; 166(10): 1382-1387. https://doi.org/10.1164/rccm.200201-050OC

[30]

Joo EY, Jeon S, Kim ST, Lee JM, Hong SB. Localized cortical thinning in patients with obstructive sleep apnea syndrome. Sleep. 2013; 36(8): 1153-1162. https://doi.org/10.5665/sleep.2876

[31]

Kamagata K, Andica C, Kato A, et al. Diffusion magnetic resonance imaging-based biomarkers for neurodegenerative diseases. Int J Mol Sci. 2021; 22(10):5216. https://doi.org/10.3390/ijms22105216

[32]

Zhang Q, Wang D, Qin W, et al. Altered resting-state brain activity in obstructive sleep apnea. Sleep. 2013; 36(5): 651-659. https://doi.org/10.5665/sleep.2620

[33]

Xiao P, Hua K, Chen F, et al. Abnormal cerebral blood flow and volumetric brain morphometry in patients with obstructive sleep apnea. Front Neurosci. 2022; 16:934166. https://doi.org/10.3389/fnins.2022.934166

[34]

Marchi NA, Pizzarotti B, Solelhac G, et al. Abnormal brain iron accumulation in obstructive sleep apnea: a quantitative MRI study in the HypnoLaus cohort. J Sleep Res. 2022; 31(6):e13698. https://doi.org/10.1111/jsr.13698

[35]

Levy P, Kohler M, McNicholas WT, et al. Obstructive sleep apnoea syndrome. Nat Rev Dis Prim. 2015; 1:15015. https://doi.org/10.1038/nrdp.2015.15

[36]

Meliante PG, Zoccali F, Cascone F, et al. Molecular pathology, oxidative stress, and biomarkers in obstructive sleep apnea. Int J Mol Sci. 2023; 24(6):5478. https://doi.org/10.3390/ijms24065478

[37]

Mancuso M, Bonanni E, LoGerfo A, et al. Oxidative stress biomarkers in patients with untreated obstructive sleep apnea syndrome. Sleep Med. 2012; 13(6): 632-636. https://doi.org/10.1016/j.sleep.2011.10.030

[38]

Pau MC, Zinellu E, Fois SS, et al. Circulating malondialdehyde soncentrations in obstructive sleep apnea (OSA): a systematic review and meta-analysis with meta-regression. Antioxidants (Basel). 2021; 10(7):1053. https://doi.org/10.3390/antiox10071053

[39]

Baril AA, Carrier J, Lafreniere A, et al. Biomarkers of dementia in obstructive sleep apnea. Sleep Med Rev. 2018; 42: 139-148. https://doi.org/10.1016/j.smrv.2018.08.001

[40]

Zhang PP, Wang YH, Han XQ, et al. [Effect of butylphthalide on oxidative stress and cognitive function in old obstructive sleep apnea hypopnea syndrome patients. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018; 32(18): 1422-1425. https://doi.org/10.13201/j.issn.1001-1781.2018.18.014

[41]

Arias-Cavieres A, Khuu MA, Nwakudu CU, Barnard JE, Dalgin G, Garcia AJ. A HIF1a-dependent pro-oxidant state disrupts synaptic plasticity and impairs spatial memory in response to intermittent hypoxia. eNeuro. 2020; 7(3):2020. https://doi.org/10.1523/ENEURO.0024-20.2020

[42]

Liu X, Ma Y, Ouyang R, et al. The relationship between inflammation and neurocognitive dysfunction in obstructive sleep apnea syndrome. J Neuroinflammation. 2020; 17(1): 229. https://doi.org/10.1186/s12974-020-01905-2

[43]

Fiedorczuk P, Olszewska E, Polecka A, Walasek M, Mroczko B, Kulczyńska-Przybik A. Investigating the role of serum and plasma IL-6, IL-8, IL-10, TNF-alpha, CRP, and S100B concentrations in obstructive sleep apnea diagnosis. Int J Mol Sci. 2023; 24(18):13875. https://doi.org/10.3390/ijms241813875

[44]

Chetan IM, Vesa SC, Domokos GB, et al. Increased levels of VCAM-1 in patients with high cardiovascular risk and obstructive sleep apnea syndrome. Biomedicines. 2023; 12(1):48. https://doi.org/10.3390/biomedicines12010048

[45]

Twarowski B, Herbet M. Inflammatory processes in Alzheimer's disease-pathomechanism, diagnosis and treatment: a review. Int J Mol Sci. 2023; 24(7):6518. https://doi.org/10.3390/ijms24076518

[46]

Nadeem R, Molnar J, Madbouly EM, et al. Serum inflammatory markers in obstructive sleep apnea: a meta-analysis. J Clin Sleep Med. 2013; 9(10): 1003-1012. https://doi.org/10.5664/jcsm.3070

[47]

Kheirandish-Gozal L, Gozal D. Obstructive sleep apnea and inflammation: proof of concept based on two illustrative cytokines. Int J Mol Sci. 2019; 20(3):459. https://doi.org/10.3390/ijms20030459

[48]

Huang YS, Guilleminault C, Hwang FM, et al. Inflammatory cytokines in pediatric obstructive sleep apnea. Medicine (Baltim). 2016; 95(41):e4944. https://doi.org/10.1097/MD.0000000000004944

[49]

Zhang K, Li YJ, Feng D, et al. Imbalance between TNFalpha and progranulin contributes to memory impairment and anxiety in sleep-deprived mice. Sci Rep. 2017; 7(1):43594. https://doi.org/10.1038/srep43594

[50]

Diaz-Roman M, Pulopulos MM, Baquero M, et al. Obstructive sleep apnea and Alzheimer's disease-related cerebrospinal fluid biomarkers in mild cognitive impairment. Sleep. 2021; 44(1). https://doi.org/10.1093/sleep/zsaa133

[51]

Sinsky J, Pichlerova K, Hanes J. Tau protein interaction partners and their roles in Alzheimer's disease and other tauopathies. Int J Mol Sci. 2021; 22(17):9207. https://doi.org/10.3390/ijms22179207

[52]

Fernandes M, Mari L, Chiaravalloti A, et al. (18)F-FDG PET, cognitive functioning, and CSF biomarkers in patients with obstructive sleep apnoea before and after continuous positive airway pressure treatment. J Neurol. 2022; 269(10): 5356-5367. https://doi.org/10.1007/s00415-022-11182-z

[53]

Liguori C, Mercuri NB, Nuccetelli M, et al. Obstructive sleep apnea may induce orexinergic system and cerebral beta-amyloid metabolism dysregulation: is it a further proof for Alzheimer's disease risk? Sleep Med. 2019; 56: 171-176. https://doi.org/10.1016/j.sleep.2019.01.003

[54]

Lardelli M. An alternative view of familial Alzheimer's disease genetics. J Alzheimers Dis. 2023; 96(1): 13-39. https://doi.org/10.3233/JAD-230313

[55]

Varga AW, Wohlleber ME, Gimenez S, et al. Reduced slow-wave sleep is associated with high cerebrospinal fluid abeta42 levels in cognitively normal elderly. Sleep. 2016; 39(11): 2041-2048. https://doi.org/10.5665/sleep.6240

[56]

Liguori C, Mercuri NB, Izzi F, et al. Obstructive sleep apnea is associated with early but possibly modifiable Alzheimer's disease biomarkers changes. Sleep. 2017; 40(5). https://doi.org/10.1093/sleep/zsx011

[57]

Elias A, Cummins T, Tyrrell R, et al. Risk of Alzheimer's disease in obstructive sleep apnea syndrome: amyloid-beta and Tau imaging. J Alzheimers Dis. 2018; 66(2): 733-741. https://doi.org/10.3233/JAD-180640

[58]

Yun CH, Lee HY, Lee SK, et al. Amyloid burden in obstructive sleep apnea. J Alzheimers Dis. 2017; 59(1): 21-29. https://doi.org/10.3233/JAD-161047

[59]

Nedergaard M, Goldman SA. Glymphatic failure as a final common pathway to dementia. Science. 2020; 370(6512): 50-56. https://doi.org/10.1126/science.abb8739

[60]

Meszaros M, Bikov A. Obstructive sleep apnoea and lipid metabolism: the summary of evidence and future perspectives in the pathophysiology of OSA-associated dyslipidaemia. Biomedicines. 2022; 10(11):2754. https://doi.org/10.3390/biomedicines10112754

[61]

Meszaros M, Horvath P, Kis A, et al. Circulating levels of clusterin and complement factor H in patients with obstructive sleep apnea. Biomark Med. 2021; 15(5): 323-330. https://doi.org/10.2217/bmm-2020-0533

[62]

Liu YH, Chen MT, He YY, et al. Cognitive impairment and depression precede increased HDL-C levels in middle-aged and older Chinese adults: cross-lagged panel analyses. Lipids Health Dis. 2024; 23(1): 288. https://doi.org/10.1186/s12944-024-02285-9

[63]

Shin HW, Cho K, Rhee CS, et al. Urine 5-eicosatetraenoic acids as diagnostic markers for obstructive sleep apnea. Antioxidants (Basel). 2021; 10(8):1242. https://doi.org/10.3390/antiox10081242

[64]

Kohli M, Sharma SK, Upadhyay V, et al. Urinary EPCR and dermcidin as potential novel biomarkers for severe adult OSA patients. Sleep Med. 2019; 64: 92-100. https://doi.org/10.1016/j.sleep.2019.07.002

[65]

Bencharit S, Redenz RG, Brody ER, Chiang H. Salivary biomarkers associated with obstructive sleep apnea: a systematic review. Expert Rev Mol Diagn. 2021; 21(2): 223-233. https://doi.org/10.1080/14737159.2021.1873132

[66]

An JR, Zhao YS, Luo LF, Guan P, Tan M, Ji ES. Huperzine A, reduces brain iron overload and alleviates cognitive deficit in mice exposed to chronic intermittent hypoxia. Life Sci. 2020; 250:117573. https://doi.org/10.1016/j.lfs.2020.117573

[67]

Khawaja I, Yingling K, Bukamur H, Abusnina W. Vitamin B(12) deficiency: a rare cause of excessive daytime sleepiness. J Clin Sleep Med. 2019; 15(9): 1365-1367. https://doi.org/10.5664/jcsm.7936

[68]

Morrell MJ, Jackson ML, Twigg GL, et al. Changes in brain morphology in patients with obstructive sleep apnoea. Thorax. 2010; 65(10): 908-914. https://doi.org/10.1136/thx.2009.126730

[69]

Baril AA, Martineau-Dussault ME, Sanchez E, et al. Obstructive sleep apnea and the brain: a focus on gray and white matter structure. Curr Neurol Neurosci Rep. 2021; 21(3): 11. https://doi.org/10.1007/s11910-021-01094-2

[70]

Nenadic I, Yotter RA, Sauer H, Gaser C. Cortical surface complexity in frontal and temporal areas varies across subgroups of schizophrenia. Hum Brain Mapp. 2014; 35(4): 1691-1699. https://doi.org/10.1002/hbm.22283

[71]

Wang J, Li Y, Ji L, et al. The complex interplay of hypoxia and sleep disturbance in gray matter structure alterations in obstructive sleep apnea patients. Front Aging Neurosci. 2023; 15:1090547. https://doi.org/10.3389/fnagi.2023.1090547

[72]

Lope-Piedrafita S. Diffusion tensor imaging (DTI). Methods Mol Biol. 2018; 1718: 103-116. https://doi.org/10.1007/978-1-4939-7531-0_7

[73]

Hattori A, Kamagata K, Kirino E, et al. White matter alterations in adult with autism spectrum disorder evaluated using diffusion kurtosis imaging. Neuroradiology. 2019; 61(12): 1343-1353. https://doi.org/10.1007/s00234-019-02238-5

[74]

Arab A, Wojna-Pelczar A, Khairnar A, Szabó N, Ruda-Kucerova J. Principles of diffusion kurtosis imaging and its role in early diagnosis of neurodegenerative disorders. Brain Res Bull. 2018; 139: 91-98. https://doi.org/10.1016/j.brainresbull.2018.01.015

[75]

Liu X, Wei Z, Chen L, et al. Effects of 3-month CPAP therapy on brain structure in obstructive sleep apnea: a diffusion tensor imaging study. Front Neurol. 2022; 13:913193. https://doi.org/10.3389/fneur.2022.913193

[76]

Chen HL, Lu CH, Lin HC, et al. White matter damage and systemic inflammation in obstructive sleep apnea. Sleep. 2015; 38(3): 361-370. https://doi.org/10.5665/sleep.4490

[77]

Kacar E, Sarinc US, Gunay E, et al. Assessment of neural alterations in obstructive sleep apnoea syndrome: can apparent diffusion coefficient measurements be useful? Clin Respir J. 2016; 10(2): 189-197. https://doi.org/10.1111/crj.12201

[78]

Tummala S, Palomares J, Kang DW, et al. Global and regional brain non-Gaussian diffusion changes in newly diagnosed patients with obstructive sleep apnea. Sleep. 2016; 39(1): 51-57. https://doi.org/10.5665/sleep.5316

[79]

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. 2022; 5(7):e2222999. https://doi.org/10.1001/jamanetworkopen.2022.22999

[80]

Zhang Q, Qin W, He X, et al. Functional disconnection of the right anterior insula in obstructive sleep apnea. Sleep Med. 2015; 16(9): 1062-1070. https://doi.org/10.1016/j.sleep.2015.04.018

[81]

Park HR, Cha J, Joo EY, Kim H. Altered cerebrocerebellar functional connectivity in patients with obstructive sleep apnea and its association with cognitive function. Sleep. 2022; 45(1). https://doi.org/10.1093/sleep/zsab209

[82]

Li HJ, Nie X, Gong HH, Zhang W, Nie S, Peng DC. Abnormal resting-state functional connectivity within the default mode network subregions in male patients with obstructive sleep apnea. Neuropsychiatr Dis Treat. 2016; 12: 203-212. https://doi.org/10.2147/NDT.S97449

[83]

Liu X, Chen L, Duan W, et al. Abnormal functional connectivity of hippocampal subdivisions in obstructive sleep apnea: a resting-state functional magnetic resonance imaging study. Front Neurosci. 2022; 16:850940. https://doi.org/10.3389/fnins.2022.850940

[84]

Hutchison RM, Womelsdorf T, Allen EA, et al. Dynamic functional connectivity: promise, issues, and interpretations. Neuroimage. 2013; 80: 360-378. https://doi.org/10.1016/j.neuroimage.2013.05.079

[85]

Li H, Li L, Li K, et al. Abnormal dynamic functional network connectivity in male obstructive sleep apnea with mild cognitive impairment: a data-driven functional magnetic resonance imaging study. Front Aging Neurosci. 2022; 14:977917. https://doi.org/10.3389/fnagi.2022.977917

[86]

Long T, Shu Y, Liu X, et al. Abnormal temporal variability of thalamo-cortical circuit in patients with moderate-to-severe obstructive sleep apnea. J Sleep Res. 2024; 33(5):e14159. https://doi.org/10.1111/jsr.14159

[87]

Zhou L, Shan X, Peng Y, et al. Reduced regional homogeneity and neurocognitive impairment in patients with moderate-to-severe obstructive sleep apnea. Sleep Med. 2020; 75: 418-427. https://doi.org/10.1016/j.sleep.2020.09.009

[88]

Shu Y, Liu X, Yu P, et al. Inherent regional brain activity changes in male obstructive sleep apnea with mild cognitive impairment: a resting-state magnetic resonance study. Front Aging Neurosci. 2022; 14:1022628. https://doi.org/10.3389/fnagi.2022.1022628

[89]

Li K, Shu Y, Liu X, et al. Dynamic regional homogeneity alterations and cognitive impairment in patients with moderate and severe obstructive sleep apnea. Front Neurosci. 2022; 16:940721. https://doi.org/10.3389/fnins.2022.940721

[90]

Li HJ, Dai XJ, Gong HH, Nie X, Zhang W, Peng DC. Aberrant spontaneous low-frequency brain activity in male patients with severe obstructive sleep apnea revealed by resting-state functional MRI. Neuropsychiatr Dis Treat. 2015; 11: 207-214. https://doi.org/10.2147/NDT.S73730

[91]

Shu Y, Chen L, Li K, et al. Abnormal cerebellar-prefrontal cortical pathways in obstructive sleep apnea with/without mild cognitive impairment. Front Neurosci. 2022; 16:1002184. https://doi.org/10.3389/fnins.2022.1002184

[92]

Santarnecchi E, Sprugnoli G, Sicilia I, et al. Thalamic altered spontaneous activity and connectivity in obstructive sleep apnea syndrome. J Neuroimaging. 2022; 32(2): 314-327. https://doi.org/10.1111/jon.12952

[93]

Xie W, Shu Y, Liu X, et al. Abnormal spontaneous brain activity and cognitive impairment in obstructive sleep apnea. Nat Sci Sleep. 2022; 14: 1575-1587. https://doi.org/10.2147/NSS.S376638

[94]

Nie S, Peng DC, Gong HH, Li HJ, Chen LT, Ye CL. Resting cerebral blood flow alteration in severe obstructive sleep apnoea: an arterial spin labelling perfusion fMRI study. Sleep Breath. 2017; 21(2): 487-495. https://doi.org/10.1007/s11325-017-1474-9

[95]

Yan L, Park HR, Kezirian EJ, et al. Altered regional cerebral blood flow in obstructive sleep apnea is associated with sleep fragmentation and oxygen desaturation. J Cereb Blood Flow Metab. 2021; 41(10): 2712-2724. https://doi.org/10.1177/0271678X211012109

[96]

Liu YT, Zhang HX, Li HJ, et al. Aberrant interhemispheric connectivity in obstructive sleep apnea-hypopnea syndrome. Front Neurol. 2018; 9:314. https://doi.org/10.3389/fneur.2018.00314

[97]

Ji Lirong WECR. Abnormal brain function changes in patients with OSAHS: a resting-state fMRI study based on VMHC. Magn Reson Imaging. 2023; 09(14): 3-18. https://doi.org/10.12015/issn.1674-8034.2023.09.003

[98]

Li H, Li L, Shao Y, et al. Abnormal intrinsic functional hubs in severe male obstructive sleep apnea: evidence from a Voxel-Wise degree centrality analysis. PLoS One. 2016; 11(10):e0164031. https://doi.org/10.1371/journal.pone.0164031

[99]

Liu C, Wei H, Gong NJ, Cronin M, Dibb R, Decker K. Quantitative susceptibility mapping: contrast mechanisms and clinical applications. Tomography. 2015; 1(1): 3-17. https://doi.org/10.18383/j.tom.2015.00136

[100]

Kang JM, Cho SE, Na KS, Kang SG. Spectral power analysis of sleep electroencephalography in subjects with different severities of obstructive sleep apnea and healthy controls. Nat Sci Sleep. 2021; 13: 477-486. https://doi.org/10.2147/NSS.S295742

[101]

Liu S, Shen J, Li Y, et al. EEG power spectral analysis of abnormal cortical activations during REM/NREM sleep in obstructive sleep apnea. Front Neurol. 2021; 12:643855. https://doi.org/10.3389/fneur.2021.643855

[102]

Wang J, Xu J, Liu S, et al. Electroencephalographic activity and cognitive function in middle-aged patients with obstructive sleep apnea before and after continuous positive airway pressure treatment. Nat Sci Sleep. 2021; 13: 1495-1506. https://doi.org/10.2147/NSS.S322426

[103]

Mullins AE, Kim JW, Wong K, et al. Sleep EEG microstructure is associated with neurobehavioural impairment after extended wakefulness in obstructive sleep apnea. Sleep Breath. 2021; 25(1): 347-354. https://doi.org/10.1007/s11325-020-02066-5

[104]

Schonauer M. Sleep spindles: timed for memory consolidation. Curr Biol. 2018; 28(11): R656-R658. https://doi.org/10.1016/j.cub.2018.03.046

[105]

Latreille V, von Ellenrieder N, Peter-Derex L, Dubeau F, Gotman J, Frauscher B. The human K-complex: insights from combined scalp-intracranial EEG recordings. Neuroimage. 2020; 213:116748. https://doi.org/10.1016/j.neuroimage.2020.116748

[106]

Parekh A, Mullins AE, Kam K, Varga AW, Rapoport DM, Ayappa I. Slow-wave activity surrounding stage N2 K-complexes and daytime function measured by psychomotor vigilance test in obstructive sleep apnea. Sleep. 2019; 42(3). https://doi.org/10.1093/sleep/zsy256

[107]

Zhu Q, Han F, Wang J, et al. Sleep spindle characteristics and relationship with memory ability in patients with obstructive sleep apnea-hypopnea syndrome. J Clin Med. 2023; 12(2):634. https://doi.org/10.3390/jcm12020634

[108]

Stevens D, Leong C, Cheung H, et al. Sleep spindle activity correlates with implicit statistical learning consolidation in untreated obstructive sleep apnea patients. Sleep Med. 2021; 86: 126-134. https://doi.org/10.1016/j.sleep.2021.01.035

[109]

Karimzadeh F, Nami M, Boostani R. Sleep microstructure dynamics and neurocognitive performance in obstructive sleep apnea syndrome patients. J Integr Neurosci. 2017; 16(2): 127-142. https://doi.org/10.3233/JIN-170004

[110]

Hartmann S, Bruni O, Ferri R, Redline S, Baumert M. Cyclic alternating pattern in children with obstructive sleep apnea and its relationship with adenotonsillectomy, behavior, cognition, and quality of life. Sleep. 2021; 44(1). https://doi.org/10.1093/sleep/zsaa145

[111]

Li N, Wang J, Wang D, et al. Correlation of sleep microstructure with daytime sleepiness and cognitive function in young and middle-aged adults with obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol. 2019; 276(12): 3525-3532. https://doi.org/10.1007/s00405-019-05529-y

[112]

Pedreno RM, Matsumura E, Silva L, et al. Influence of obstructive sleep apnea on auditory event-related potentials. Sleep Breath. 2022; 26(1): 315-323. https://doi.org/10.1007/s11325-021-02406-z

[113]

Lv R, Nie S, Liu Z, et al. Dysfunction in automatic processing of emotional facial expressions in patients with obstructive sleep apnea syndrome: an event-related potential sudy. Nat Sci Sleep. 2020; 12: 637-647. https://doi.org/10.2147/NSS.S267775

[114]

Yang C, Wang C, Chen X, et al. Event-related potential assessment of visual perception abnormality in patients with obstructive sleep apnea: a preliminary study. Front Hum Neurosci. 2022; 16:895826. https://doi.org/10.3389/fnhum.2022.895826

[115]

D'Rozario AL, Kim JW, Wong KK, et al. A new EEG biomarker of neurobehavioural impairment and sleepiness in sleep apnea patients and controls during extended wakefulness. Clin Neurophysiol. 2013; 124(8): 1605-1614. https://doi.org/10.1016/j.clinph.2013.02.022

[116]

Tarailis P, Koenig T, Michel CM, Griškova-Bulanova I. The functional aspects of resting EEG microstates: a systematic review. Brain Topogr. 2024; 37(2): 181-217. https://doi.org/10.1007/s10548-023-00958-9

[117]

Xiong X, Ren Y, Gao S, et al. EEG microstate in obstructive sleep apnea patients. Sci Rep. 2021; 11(1):17178. https://doi.org/10.1038/s41598-021-95749-2

[118]

Younes M, Azarbarzin A, Reid M, Mazzotti DR, Redline S. Characteristics and reproducibility of novel sleep EEG biomarkers and their variation with sleep apnea and insomnia in a large community-based cohort. Sleep. 2021; 44(10). https://doi.org/10.1093/sleep/zsab145

[119]

Wang ML, Wang C, Tuo M, et al. Cognitive effects of treating obstructive sleep apnea: a meta-analysis of randomized controlled trials. J Alzheimers Dis. 2020; 75(3): 705-715. https://doi.org/10.3233/JAD-200088

[120]

Dalmases M, Sole-Padulles C, Torres M, et al. Effect of CPAP on cognition, brain function, and structure among elderly patients with OSA: a randomized pilot study. Chest. 2015; 148(5): 1214-1223. https://doi.org/10.1378/chest.15-0171

[121]

Kushida CA, Nichols DA, Holmes TH, et al. Effects of continuous positive airway pressure on neurocognitive function in obstructive sleep apnea patients: the apnea positive pressure long-term efficacy study (APPLES). Sleep. 2012; 35(12): 1593-1602. https://doi.org/10.5665/sleep.2226

[122]

Pollicina I, Maniaci A, Lechien JR, et al. Neurocognitive performance improvement after obstructive sleep apnea treatment: state of the art. Behav Sci (Basel). 2021; 11(12):180. https://doi.org/10.3390/bs11120180

[123]

Durtette A, Dargent B, Gierski F, et al. Impact of continuous positive airway pressure on cognitive functions in adult patients with obstructive sleep apnea: a systematic review and meta-analysis. Sleep Med. 2024; 123: 7-21. https://doi.org/10.1016/j.sleep.2024.08.019

[124]

Turnbull CD, Rossi VA, Santer P, et al. Effect of OSA on hypoxic and inflammatory markers during CPAP withdrawal: further evidence from three randomized control trials. Respirology. 2017; 22(4): 793-799. https://doi.org/10.1111/resp.12946

[125]

Thunstrom E, Glantz H, Yucel-Lindberg T, Lindberg K, Saygin M, Peker Y. CPAP does not reduce inflammatory biomarkers in patients with coronary artery disease and nonsleepy obstructive sleep apnea: a randomized controlled trial. Sleep. 2017; 40(11). https://doi.org/10.1093/sleep/zsx157

[126]

Munoz-Hernandez R, Vallejo-Vaz AJ, Sanchez AA, et al. Obstructive sleep apnoea syndrome, endothelial function and markers of endothelialization. Changes after CPAP. PLoS One. 2015; 10(3):e0122091. https://doi.org/10.1371/journal.pone.0122091

[127]

Canessa N, Castronovo V, Cappa SF, et al. Obstructive sleep apnea: brain structural changes and neurocognitive function before and after treatment. Am J Respir Crit Care Med. 2011; 183(10): 1419-1426. https://doi.org/10.1164/rccm.201005-0693OC

[128]

Huynh NT, Prilipko O, Kushida CA, Guilleminault C. Volumetric brain morphometry changes in patients with obstructive sleep apnea syndrome: effects of CPAP treatment and literature review. Front Neurol. 2014; 5:58. https://doi.org/10.3389/fneur.2014.00058

[129]

Castronovo V, Scifo P, Castellano A, et al. White matter integrity in obstructive sleep apnea before and after treatment. Sleep. 2014; 37(9): 1465-1475. https://doi.org/10.5665/sleep.3994

[130]

Huang L, Li H, Shu Y, et al. Changes in functional connectivity of hippocampal subregions in patients with obstructive sleep apnea after six months of continuous positive airway pressure treatment. Brain Sci. 2023; 13(5):838. https://doi.org/10.3390/brainsci13050838

[131]

Li H, Li L, Kong L, et al. Frequency-specific regional homogeneity alterations and cognitive function in obstructive sleep apnea before and after short-term continuous positive airway pressure treatment. Nat Sci Sleep. 2021; 13: 2221-2238. https://doi.org/10.2147/NSS.S344842

[132]

Song X, Roy B, Vacas S, et al. Brain regional homogeneity changes after short-term positive airway pressure treatment in patients with obstructive sleep apnea. Sleep Med. 2022; 91: 12-20. https://doi.org/10.1016/j.sleep.2022.02.005

[133]

Li P, Shu Y, Liu X, et al. The effects of CPAP treatment on resting-state network centrality in obstructive sleep apnea patients. Front Neurol. 2022; 13:801121. https://doi.org/10.3389/fneur.2022.801121

[134]

D'Rozario AL, Hoyos CM, Wong K, et al. Improvements in cognitive function and quantitative sleep electroencephalogram in obstructive sleep apnea after six months of continuous positive airway pressure treatment. Sleep. 2022; 45(6). https://doi.org/10.1093/sleep/zsac013

[135]

Chen S, Li Q, Zou X, et al. Effects of CPAP treatment on electroencephalographic activity in patients with obstructive sleep apnea syndrome during deep sleep with consideration of cyclic alternating pattern. Nat Sci Sleep. 2022; 14: 2075-2089. https://doi.org/10.2147/NSS.S382305

[136]

Corretti MC, Anderson TJ, Benjamin EJ, et al. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the international brachial artery reactivity task force. J Am Coll Cardiol. 2002; 39(2): 257-265. https://doi.org/10.1016/s0735-1097(01)01746-6

[137]

Owen JE, BenediktsdOttir B, Gislason T, Robinson SR. Neuropathological investigation of cell layer thickness and myelination in the hippocampus of people with obstructive sleep apnea. Sleep. 2019; 42(1). https://doi.org/10.1093/sleep/zsy199

[138]

D'Rozario AL, Cross NE, Vakulin A, et al. Quantitative electroencephalogram measures in adult obstructive sleep apnea - potential biomarkers of neurobehavioural functioning. Sleep Med Rev. 2017; 36: 29-42. https://doi.org/10.1016/j.smrv.2016.10.003

[139]

Greneche J, Krieger J, Bertrand F, Erhardt C, Muzet A, Tassi P. Effect of continuous positive airway pressure treatment on the subsequent EEG spectral power and sleepiness over sustained wakefulness in patients with obstructive sleep apnea-hypopnea syndrome. Clin Neurophysiol. 2011; 122(5): 958-965. https://doi.org/10.1016/j.clinph.2010.09.003

RIGHTS & PERMISSIONS

2025 The Author(s). Sleep Research published by John Wiley & Sons Australia, Ltd on behalf of Chinese Sleep Research Society.

AI Summary AI Mindmap
PDF

99

Accesses

0

Citation

Detail

Sections
Recommended

AI思维导图

/