The association between obstructive sleep apnea risk and cognitive disorders: a population-based study

J Clin Sleep Med. 2022 Apr 1;18(4):1177-1185. doi: 10.5664/jcsm.9832.


Study objectives: To examine the association between obstructive sleep apnea (OSA) risk and cognitive disorders among US adults.

Methods: Data from the 2016 wave of the Health and Retirement Study (HRS) were utilized. Probable OSA cases were identified with survey items that resembled critical elements of a clinically validated OSA screen (STOP-Bang questionnaire). Weighted prevalences of cognitive impairment not dementia (CIND) and dementia among individuals with and without probable OSA were assessed. Cross-sectional analyses of associations between OSA risk and cognitive outcomes, along with effect modification by race and ethnicity, were estimated using imputed data.

Results: Of the 20,910 HRS participants, 60% had probable OSA. CIND and dementia were more common among adults with probable OSA as compared with those without (12.7% vs 8.0% for CIND; 3.2% vs 2.0% for dementia). Probable OSA was associated with CIND (odds ratio [OR] = 1.22, 95% confidence interval [CI] = 1.08-1.37) and dementia (OR = 1.27, 95% CI = 1.04-1.54). Race/ethnicity significantly modified the association between probable OSA and CIND, with a higher risk for CIND in Whites (OR = 1.35, 95% CI = 1.17-1.57) as compared with non-Whites (OR = 0.98, 95% CI = 0.81-1.19).

Conclusions: CIND and dementia are more common among older adults who are at high risk for OSA, as compared with low-risk individuals. These data highlight the importance of consideration of OSA risk in large-scale studies of OSA and cognitive disorders.

Citation: Shieu MM, Dunietz GL, Paulson HL, Chervin RD, Braley TJ. The association between obstructive sleep apnea risk and cognitive disorders: a population-based study. J Clin Sleep Med. 2022;18(4):1177-1185.

Keywords: cognitive disorders; dementia; effect modification; obstructive sleep apnea.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Cognition
  • Cognition Disorders*
  • Cognitive Dysfunction* / epidemiology
  • Cross-Sectional Studies
  • Humans
  • Sleep Apnea, Obstructive* / complications
  • Sleep Apnea, Obstructive* / epidemiology