Proposed Mechanisms of Cognitive Dysfunction in Obstructive Sleep Apnea

Patients with obstructive sleep apnea (OSA) are likely to develop cognitive impairments, including problems with concentration, memory, and executive function. The etiology of these deficits is not fully resolved, although sleep fragmentation, excessive sleepiness, and hypoxemia appear to interact to produce neurologic consequences in patients with OSA. Disturbingly, a proportion of the cognitive dysfunction caused by hypoxic brain damage may be irreversible. Many patients with OSA will present in the primary care setting and may not know that they have a sleep disorder. Vigilance for the cognitive symptoms of OSA could assist in recognition by primary care physicians and aid in the prevention of lasting neuro-cognitive sequelae in this patient population.