Impact of Obstructive Sleep Apnea on the Central Nervous System

Paul Knoepflmacher, MD

Clinical Instructor of Medicine
Mount Sinai School of Medicine
New York, New York

Neuroimaging studies and cognitive testing show that patients with obstructive sleep apnea (OSA) have potentially irreversible structural and functional changes in brain regions that govern cognitive functioning. These alterations likely explain associated impairments in waking performance and behavior, as well as the increased risk of accidents. For example, patients with OSA have an approximately 3-fold greater risk of motor vehicle accidents compared with the general population. Prompt diagnosis and CPAP therapy can ameliorate these symptoms, although some patients may require additional tailoring of treatment regimens. Furthermore, physicians should routinely ask these patients about work performance, the ability to concentrate and maintain attention, mood disturbances, and difficulties performing activities of daily living, such as driving. Recent neuroimaging studies presented at the 11th International Symposium on Sleep and Breathing addressed pathogenic mechanisms that contribute to OSA-related impairments in performance and behavior. These studies highlight the importance of obtaining a thorough physical examination and patient history, including inquiries into cognitive functioning and waking performance.

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