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Symptom subtypes and cognitive function in a clinic-based OSA cohort: a multi-centre Canadian study.

Authors
  • Allen, Aj Hirsch1
  • Beaudin, Andrew E2
  • Fox, Nurit3
  • Raneri, Jill K4
  • Skomro, Robert P5
  • Hanly, Patrick J6
  • Mazzotti, Diego R7
  • Keenan, Brendan T7
  • Smith, Eric E8
  • Goodfellow, Sebastian D9
  • Ayas, Najib T10
  • 1 Department of Medicine, Respiratory and Critical Care Divisions, University of British Columbia, Vancouver, BC, Canada; Canadian Sleep and Circadian Network, Canada. , (Canada)
  • 2 Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Canadian Sleep and Circadian Network, Canada. , (Canada)
  • 3 Department of Medicine, Respiratory and Critical Care Divisions, University of British Columbia, Vancouver, BC, Canada. , (Canada)
  • 4 Sleep Centre, Foothills Medical Centre, Calgary, AB, Canada. , (Canada)
  • 5 Division of Respirology, Critical Care and Sleep Medicine, University of Saskatchewan, Saskatoon, SK, Canada; Canadian Sleep and Circadian Network, Canada. , (Canada)
  • 6 Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Sleep Centre, Foothills Medical Centre, Calgary, AB, Canada; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Canadian Sleep and Circadian Network, Canada. , (Canada)
  • 7 Division of Sleep Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
  • 8 Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. , (Canada)
  • 9 Department of Civil and Mineral Engineering, University of Toronto, Toronto, ON, Canada. , (Canada)
  • 10 Department of Medicine, Respiratory and Critical Care Divisions, University of British Columbia, Vancouver, BC, Canada; Canadian Sleep and Circadian Network, Canada. Electronic address: [email protected] , (Canada)
Type
Published Article
Journal
Sleep medicine
Publication Date
Oct 01, 2020
Volume
74
Pages
92–98
Identifiers
DOI: 10.1016/j.sleep.2020.05.001
PMID: 32841852
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Distinct symptom subtypes are found in patients with OSA. The association between these subtypes and neurocognitive function is unclear. The purposes of this study were to assess whether OSA symptom subtypes are present in a cohort of Canadian patients with suspected OSA and evaluate the relationship between subtypes and neurocognitive function. Patients with suspected OSA who completed a symptom questionnaire and underwent testing for OSA were included. Symptom subtypes were identified using latent class analysis. Associations between subtypes and neurocognitive outcomes (Montreal Cognitive Assessment [MoCA], Rey Auditory Verbal Learning Test [RAVLT], Wechsler Adult Intelligence Scale [WAIS-IV], Digit-Symbol Coding subtest [DSC]) were assessed using analysis of covariance (ANCOVA), controlling for relevant covariates. Four symptom subtypes were identified in patients with OSA (oxygen desaturation index ≥5 events/hour). Three were similar to prior studies, including the Excessively Sleepy (N=405), Disturbed Sleep (N=382) and Minimally Symptomatic (N=280), and one was a novel subtype in our sample defined as Excessively Sleepy with Disturbed Sleep (N=247). After covariate adjustment, statistically significant differences among subtypes (p=0.037) and among subtypes and patients without OSA (p=0.044) were observed in DSC scores; the Minimally Symptomatic subtype had evidence of higher DSC scores than all other groups, including non-OSA patients. No differences were seen in MoCA or RAVLT. Results support the existence of previously identified OSA symptom subtypes of excessively sleepy, disturbed sleep and minimally symptomatic in a clinical sample from Canada. Subtypes were not consistently associated with neurocognitive function across multiple instruments. Copyright © 2020 Elsevier B.V. All rights reserved.

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