Older adults at greater risk for Alzheimer's disease show stronger associations between sleep apnea severity and verbal memory.

Autor:	Lui K; San Diego State University/University of California San Diego, Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA., Dave A; Department of Cognitive Sciences, University of California, Irvine., Sprecher K; Department of Population Health Sciences, University of Wisconsin-Madison., Chappel-Farley M; Department of Neurobiology and Behavior, University of California, Irvine., Riedner B; Department of Psychiatry, University of Wisconsin-Madison., Heston M; Department of Medicine, University of Wisconsin-Madison., Taylor C; Department of Neuroscience, University of Kentucky., Carlsson C; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison., Okonkwo O; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison., Asthana S; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison., Johnson S; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison., Bendlin B; Department of Medicine, University of Wisconsin-Madison., Mander B; Department of Psychiatry and Human Behavior, University of California, Irvine., Benca R; Department of Psychiatry and Behavioral Medicine, Wake Forest University.
Jazyk:	angličtina
Zdroj:	Research square [Res Sq] 2023 Dec 02. Date of Electronic Publication: 2023 Dec 02.
DOI:	10.21203/rs.3.rs-3683218/v1
Abstrakt:	Background: Obstructive sleep apnea (OSA) increases risk for cognitive decline and Alzheimer's disease (AD). While the underlying mechanisms remain unclear, hypoxemia during OSA has been implicated in cognitive impairment. OSA during rapid eye movement (REM) sleep is usually more severe than in non-rapid eye movement (NREM) sleep, but the relative effect of oxyhemoglobin desaturation during REM versus NREM sleep on memory is not completely characterized. Here, we examined the impact of OSA, as well as the moderating effects of AD risk factors, on verbal memory in a sample of middle-aged and older adults with heightened AD risk. Methods: Eighty-one adults (mean age:61.7±6.0 years, 62% females, 32% apolipoprotein E ε4 allele ( APOE4 ) carriers, and 70% with parental history of AD) underwent clinical polysomnography including assessment of OSA. OSA features were derived in total, NREM, and REM sleep. REM-NREM ratios of OSA features were also calculated. Verbal memory was assessed with the Rey Auditory Verbal Learning Test (RAVLT). Multiple regression models evaluated the relationships between OSA features and RAVLT scores while adjusting for sex, age, time between assessments, education years, body mass index (BMI), and APOE4 status or parental history of AD. The significant main effects of OSA features on RAVLT performance and the moderating effects of AD risk factors (i.e., sex, age, APOE4 status, and parental history of AD) were examined. Results: Apnea-hypopnea index (AHI), respiratory disturbance index (RDI), and oxyhemoglobin desaturation index (ODI) during REM sleep were negatively associated with RAVLT total learning and long-delay recall. Further, greater REM-NREM ratios of AHI, RDI, and ODI (i.e., more events in REM than NREM) were related to worse total learning and recall. We found specifically that the negative association between REM ODI and total learning was driven by adults 60+ years old. In addition, the negative relationships between REM-NREM ODI ratio and total learning and REM-NREM RDI ratio and long-delay recall were driven by APOE4 carriers. Conclusion: Greater OSA severity, particularly during REM sleep, negatively affects verbal memory, especially for people with greater AD risk. These findings underscore the potential importance of proactive screening and treatment of REM OSA even if overall AHI appears low. Competing Interests: Competing Interests Dr. Mander has served as a consultant for Eisai Co., Ltd. Dr. Benca has served as a consultant for Eisai, Genomind, Idorsia, Jazz, Merck, and Sunovion. Dr. Riedner has several patents related to sleep technology jointly held by the Wisconsin Alumni Research Foundation and Philips Healthcare, and in addition to grant support, has given several lectures sponsored by Philips Healthcare.
Databáze:	MEDLINE
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