• Yan Zhang, Wanhua Wang, Sijie Cai, Qi Sheng, Shenggui Pan, Fang Shen, Qing Tang, and Yang Liu.
• Department of Neurology, The Kunshan Affiliated Hospital of Jiangsu University, 215300 Kunshan, China; Department of Neurology, The First People's Hospital of Kunshan, 215300 Kunshan, China. Electronic address: 2573560757@qq.com.
• Sleep Med. 2017 May 1; 33: 183-190.

BackgroundObstructive sleep apnea (OSA) is very common in stroke survivors. It potentially worsens the cognitive dysfunction and inhibits their functional recovery. However, whether OSA independently damages the cognitive function in stroke patients is unclear. A simple method for evaluating OSA-induced cognitive impairment is also missing.MethodsForty-four stroke patients six weeks after onset and 24 non-stroke patients with snoring were recruited for the polysomnographic study of OSA and sleep architecture. Their cognitive status was evaluated with a validated Chinese version of Cambridge Prospective Memory Test. The relationship between memory deficits and respiratory, sleeping, and dementia-related clinical variables were analyzed with correlation and multiple linear regression tests.ResultsOSA significantly and independently damaged time- and event-based prospective memory in stroke patients, although it had less power than the stroke itself. The impairment of prospective memory was correlated with increased apnea-hypopnea index, decreased minimal and mean levels of peripheral oxygen saturation, and disrupted sleeping continuity (reduced sleep efficiency and increased microarousal index). The further regression analysis identified minimal levels of peripheral oxygen saturation and sleep efficiency to be the two most important predictors for the decreased time-based prospective memory in stroke patients.ConclusionsOSA independently contributes to the cognitive dysfunction in stroke patients, potentially through OSA-caused hypoxemia and sleeping discontinuity. The prospective memory test is a simple but sensitive method to detect OSA-induced cognitive impairment in stroke patients. Proper therapies of OSA might improve the cognitive function and increase the life quality of stroke patients.Copyright © 2017 Elsevier B.V. All rights reserved.

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