The Effect of Obstructive Sleep Apnea on Cognitive Decline and Aging: A Review of the Risk and Protective Factors

Document Type : Original Article

Authors

1 Nursing Specialist at King Salman Armed Forces Hospital, Saudi Arabia

2 Nursing technician at King Salman Armed Forces Hospital, Saudi Arabia

3 Pharmaceutical at King Salman Armed Forces Hospital, Saudi Arabia

4 Dental technician at King Salman Armed Forces Hospital, Saudi Arabia

Abstract

Obstructive sleep apnea (OSA) is increasingly being recognized and realized as a strong potential risk factor that can potentially exacerbate the development of cognitive decline and the development of dementia, including conditions like Alzheimer's disease (AD). This review article seeks to summarize and integrate the current evidence base that examines the link between OSA and cognitive impairment. It has a specific focus on the wide range of mechanisms underlying this complex relationship, as well as the individual factors that might worsen or potentially decrease this crucial link. In our review, we discuss several modifiable risk factors that influence health and well-being, with an emphasis on factors including age, sex, experience of menopause, obesity, diabetes, hypertension, cardiovascular disease, smoking status, alcohol consumption levels, depression, exposure to air pollution, and presence of the Apolipoprotein E ε4 (ApoE4) allele. Aside from these risk factors, we discuss protective factors that buffer against risks, including regular exercise and the concept of cognitive reserve, or the brain's resilience to damage. This review aims to highlight the variable and often conflicting results that have been described in numerous epidemiological studies and emphasizes the urgent need for future research studies attempting to better understand how these various factors interact with obstructive sleep apnea (OSA) to ultimately influence cognitive outcomes in individuals. It may be possible to identify those at increased risk of cognitive impairment from OSA, which would enhance clinical decision-making and guide targeted interventions aimed at preventing or delaying dementia.

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