Sleep Apnea Effects on Memory: Consequences and Mechanisms

2015 ABSM Junior Faculty Research Award

Andrew Varga, MD, PhD
Icahn School of Medicine at Mount Sinai

Key Project Outcomes

OSA occurs when the muscles and tissues surrounding the upper airway collapse partially or completely during sleep, resulting in a period where breathing stops or is significantly attenuated before the airway opens again. This phenomenon occurs repeatedly during sleep; in individuals with severe OSA, it can occur nearly every minute or more. OSA is thought to have at least 2 main consequences: 1) levels of oxygen in the blood go down, and then go up again when the airway reopens. This is called intermittent hypoxia (IH). 2) when the airway reopens, a small arousal occurs. Although this arousal may go unnoticed by the individual, it nonetheless fragments sleep and can make some people sleepy the following day, even if the total sleep duration is long. Sleep architecture is broadly divided into non-REM and REM stages. OSA can occur in either non-REM or REM sleep, but because these stages of sleep are very different, it is possible there are may be differential effects of OSA in either stage.

This project investigated whether OSA limited to non-REM sleep was deleterious to the processing of spatial navigational memory. Our preliminary data suggest that the benefit of normally consolidated sleep on spatial navigational memory is reduced with OSA is introduced in non-REM sleep, without a significant impact on attention during a psychomotor vigilance test.

This project also set out to evaluate potential differences in the effect of OSA when OSA either did or did not contain intermittent hypoxia. We developed a novel paradigm in which to assess this, by withdrawing CPAP therapy for OSA either with or without supplemental oxygen. Our preliminary data suggest that we can create a unique form of OSA which is primarily composed of sleep fragmentation and in which the intermittent hypoxia is significantly limited. Using this model, our preliminary data further suggest that either form of OSA results in reduced spatial navigational memory versus normally consolidated sleep. This suggests that while intermittent hypoxia may be detrimental, sleep fragmentation from OSA alone is sufficient to negatively impact spatial navigational memory.

Journal Articles

SLEEP

Obstructive Sleep Apnea and Longitudinal Alzheimer’s disease biomarker changes

MOLECULAR NEURODEGENERATION

Sleep oscillation-specific associations with Alzheimer’s disease CSF biomarkers: novel roles for sleep spindles and tau

SLEEP

Slow wave activity surrounding stage N2 K-complexes and daytime function measured by psychomotor vigilance test in obstructive sleep apnea

Journal of Alzheimer’s Disease

The Relationship between Obstructive Sleep Apnea and Alzheimer’s Disease

Nature and Science of Sleep

Role of Normal Sleep and Sleep Apnea in Human Memory Processing

Sleep and Breathing

REM obstructive sleep apnea: risk for adverse health outcomes and novel treatments

American Journal of Respiratory and Critical Care Medicine

Obstructive Sleep Apnea Severity Affects Amyloid Burden in Cognitively Normal Elderly: A Longitudinal Study

American Journal of Respiratory and Critical Care Medicine

Obstructive Sleep Apnea and Cardiovascular Disease. REM Sleep Matters!

Journal of Neuroscience Methods

Multichannel sleep spindle detection using sparse low-rank optimization

SLEEP

Reduced Slow-Wave Sleep Is Associated with High Cerebrospinal Fluid Aβ42 Levels in Cognitively Normal Elderly

Neurobiology of Aging

Effects of aging on slow-wave sleep dynamics and human spatial navigational memory consolidation

Sleep Medicine Reviews

Candidate mechanisms underlying the association between sleep-wake disruptions and Alzheimer’s disease

SLEEP

Orexin-A is Associated with Increases in Cerebrospinal Fluid Phosphorylated-Tau in Cognitively Normal Elderly Subjects