TBI, OSA Combination Affects Cognitive Function

by U.S. Medicine

July 7, 2017

WASHINGTON—Patients with TBI are considered to be at high risk for the development of sleep disorders, especially obstructive sleep apnea (OSA).

In a study published in the journal Neurology, researchers posited that the combination of traumatic brain injury (TBI) and untreated OSA might compound consequences of both, such as cognitive dysfunction, which can greatly affect all aspects of functioning and quality of life.1

To determine relationships between polysomnographic and clinical sleep measures and performance on cognitive testing in veterans with mild/moderate TBI and OSA, researchers from the Washington D.C. VAMC conducted a prospective pilot study examining veterans diagnosed with both conditions.

Results indicated that the Hypopnea Index was associated with the Stroop Interference score, which measures executive function and response inhibition. The number of blast injuries was inversely related to sleep efficiency, total sleep time in nonrapid eye movement (NREM) sleep and performance in a section of the Rey Auditory Verbal Learning Test which evaluates immediate memory.

The Detectability score, which assesses attention, on the Conners’ Continuous Performance Test III was correlated with reductions in rapid eye movement (REM) sleep. Higher scores on the Epworth Sleepiness Scale predicted performance on components of Digit Span, a subtest from the Wechsler Adult Intelligence Scale-Fourth Edition that measures attention and working memory.

“In our prospective pilot study of veterans with TBI and OSA, sleep-disordered breathing and sleep disturbances were significantly associated with inferior performance on cognitive measures of executive function and attention respectively. Increased exposure to blasts also had a significant correlation with sleep architecture changes and diminished memory,” study authors concluded. “Treatment of OSA in veterans with TBI could offer new opportunities to improve cognitive function and positively impact rehabilitation potential for these patients.”

  1. Kataria L, Sundahl C, Skalina L, Shah M, Balish M, Chapman J. A Pilot Study of Cognition in Veterans with Traumatic Brain Injury and Obstructive Sleep Apnea (S14.008). April 18, 2017, Vol. 88, No. 16 Supplement S14.008

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