Harding Christian D, Holloway Breanna M, DeYoung Pamela N, Kwan Crystal, Djonlagic Ina, Ancoli-Israel Sonia, Banks Sarah J, Malhotra Atul
Division of Pulmonary, Critical Care, Sleep Medicine, and Physiology, University of California, San Diego, La Jolla, California.
Department of Psychiatry, University of California, San Diego, La Jolla, California.
J Clin Sleep Med. 2025 Jul 1;21(7):1217-1226. doi: 10.5664/jcsm.11648.
Aging markedly increases the risk of both Alzheimer's disease and obstructive sleep apnea (OSA). Memory deficits, an early indicator of Alzheimer's disease, can be reduced in those of middle age with OSA through treatment, with positive-airway pressure being the first-line treatment standard. Here, we use natural variation in the OSA severity of an older-aged cohort to investigate whether hypoxia or sleep quality predicts sleep-dependent memory consolidation (SDMC).
Participants aged 65-85 years not currently receiving OSA treatment were recruited from the San Diego community via advertisement and referrals from other sleep studies. Participants undertook a computerized neurocognitive battery and overnight polysomnography. SDMC was measured using a word-pair associates task. Two linear regression analyses assessed associations between (1) SDMC and hypoxia metrics and (2) SDMC and sleep quality metrics.
The study included 67 participants (36 females, 31 males), most of whom presented with moderate or severe OSA. No significant associations were present in the hypoxia model. A negative association between Epworth Sleepiness Scale score and SDMC was the only significant relationship in the sleep-quality model. There was also a mild univariate correlation between Epworth Sleepiness Scale score and a second daytime function measure, the psychomotor vigilance task.
Objective measures of OSA pathology including hypoxia and sleep fragmentation were not associated with memory; however, Epworth Sleepiness Scale score, a subjective measure of daytime sleepiness, was associated with poorer memory task performance. This highlights the importance of considering subjective perceptions of sleep quality and daytime function in cognitive health outcomes of patients with OSA, particularly in older adults, in whom the myriad comorbidities that contribute to memory deficits may integrate.
Registry: ClinicalTrials.gov; Name: Is Obstructive Sleep Apnea Important in the Development of Alzheimer's Disease?; URL: https://clinicaltrials.gov/study/NCT05094271; Identifier: NCT05094271.
Harding CD, Holloway BM, DeYoung PN, et al. Subjective daytime sleepiness, not sleep quality or hypoxia, predicts sleep-dependent memory consolidation in a cohort of older adults. 2025;21(7):1217-1226.
衰老显著增加了患阿尔茨海默病和阻塞性睡眠呼吸暂停（OSA）的风险。记忆缺陷是阿尔茨海默病的早期指标，中年OSA患者通过治疗可减轻记忆缺陷，持续气道正压通气是一线治疗标准。在此，我们利用老年队列中OSA严重程度的自然变异，研究低氧或睡眠质量是否能预测睡眠依赖性记忆巩固（SDMC）。
通过广告招募以及其他睡眠研究的推荐，从圣地亚哥社区招募了年龄在65 - 85岁、目前未接受OSA治疗的参与者。参与者接受了计算机化神经认知测试和整夜多导睡眠监测。使用单词配对联想任务测量SDMC。两项线性回归分析评估了（1）SDMC与低氧指标之间以及（2）SDMC与睡眠质量指标之间的关联。
该研究纳入了67名参与者（36名女性，31名男性），其中大多数患有中度或重度OSA。在低氧模型中未发现显著关联。在睡眠质量模型中，爱泼沃斯嗜睡量表评分与SDMC之间的负相关是唯一的显著关系。爱泼沃斯嗜睡量表评分与另一项白天功能测量指标——精神运动警觉任务之间也存在轻度单变量相关性。
包括低氧和睡眠片段化在内的OSA病理学客观指标与记忆无关；然而，爱泼沃斯嗜睡量表评分，一项白天嗜睡的主观测量指标，与较差的记忆任务表现相关。这凸显了在OSA患者，尤其是老年患者的认知健康结果中考虑睡眠质量和白天功能主观感受的重要性，在老年患者中，导致记忆缺陷的众多合并症可能相互影响。
注册机构：ClinicalTrials.gov；名称：阻塞性睡眠呼吸暂停在阿尔茨海默病发展中重要吗？；网址：https://clinicaltrials.gov/study/NCT05094271；标识符：NCT05094271。
哈丁CD，霍洛韦BM，德扬PN等。主观白天嗜睡而非睡眠质量或低氧可预测老年人群的睡眠依赖性记忆巩固。2025；21(7):1217 - 1226。
