Cognitive Complaints in Patients with Suspected Obstructive Sleep Apnea Are Associated with Sleepiness, Fatigue, and Anxiety, Not with Final Diagnosis or Objective Cognitive Impairment.

Abstract

This study examined the nature, severity, and predictors of cognitive complaints in patients referred for suspected obstructive sleep apnea (OSA). The sample included 127 patients classified as no OSA (AHI, apnea/hypopnea index < 5, N = 32), mild OSA (AHI 5-15, N = 46), moderate OSA (AHI 15-30, N = 25), or severe OSA (AHI > 30, N = 24), and 53 healthy controls (HCs), matched for age, sex, education, and IQ. Cognitive complaints were assessed using the Cognitive Failure Questionnaire (CFQ) and the Behavioral Rating Inventory of Executive Functioning Adult Version (BRIEF-A). Regression analyses examined predictors of cognitive complaints including AHI, sleepiness, anxiety, depression, fatigue, and neuropsychological performance. Compared to HCs, those with mild OSA reported more forgetfulness, distractibility, and working memory issues, while those with severe OSA reported more difficulties with initiative, both with large effect sizes. Cognitive complaints were linked to sleepiness, anxiety, and fatigue (ß's 0.29-0.37), but not AHI or cognitive performance. Cognitive complaints were not specific to subjects with OSA but were also common among individuals with sleep complaints suspected for OSA. In conclusion, cognitive complaints were associated with anxiety, fatigue, and sleepiness rather than objective cognitive performance or impairment.