Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada.
J Sleep Res. 2023 Oct;32(5):e13831. doi: 10.1111/jsr.13831. Epub 2023 Mar 20.
Obstructive sleep apnea has been associated with cognitive impairment and may be linked to disorders of cognitive function. These associations may be a result of intermittent hypoxaemia, sleep fragmentation and changes in sleep microstructure in obstructive sleep apnea. Current clinical metrics of obstructive sleep apnea, such as the apnea-hypopnea index, are poor predictors of cognitive outcomes in obstructive sleep apnea. Sleep microstructure features, which can be identified on sleep electroencephalography of traditional overnight polysomnography, are increasingly being characterized in obstructive sleep apnea and may better predict cognitive outcomes. Here, we summarize the literature on several major sleep electroencephalography features (slow-wave activity, sleep spindles, K-complexes, cyclic alternating patterns, rapid eye movement sleep quantitative electroencephalography, odds ratio product) identified in obstructive sleep apnea. We will review the associations between these sleep electroencephalography features and cognition in obstructive sleep apnea, and examine how treatment of obstructive sleep apnea affects these associations. Lastly, evolving technologies in sleep electroencephalography analyses will also be discussed (e.g. high-density electroencephalography, machine learning) as potential predictors of cognitive function in obstructive sleep apnea.
阻塞性睡眠呼吸暂停与认知障碍有关，可能与认知功能障碍有关。这些关联可能是间歇性低氧血症、睡眠碎片化和阻塞性睡眠呼吸暂停中睡眠微结构变化的结果。阻塞性睡眠呼吸暂停的当前临床指标，如呼吸暂停-低通气指数，是阻塞性睡眠呼吸暂停认知结局的不良预测指标。在传统的整夜多导睡眠图中，可以在睡眠脑电图上识别出睡眠微结构特征，这些特征在阻塞性睡眠呼吸暂停中越来越受到关注，并且可能更好地预测认知结局。在这里，我们总结了阻塞性睡眠呼吸暂停中几种主要的睡眠脑电图特征（慢波活动、睡眠纺锤波、K-复合波、周期性交替模式、快速眼动睡眠定量脑电图、优势比乘积）的文献。我们将回顾这些睡眠脑电图特征与阻塞性睡眠呼吸暂停中的认知之间的关联，并检查阻塞性睡眠呼吸暂停的治疗如何影响这些关联。最后，还将讨论睡眠脑电图分析中的新兴技术（例如高密度脑电图、机器学习），作为阻塞性睡眠呼吸暂停中认知功能的潜在预测指标。
