Subjective and objective cognitive impairment in patients with obstructive sleep apnea
Bibliographic record
Abstract
Abstract Background Obstructive sleep apnea (OSA) is associated with cognitive impairment (CI). We aimed to study subjective cognitive complaint (SCC) and objective cognitive scores, and its relation to polysomnography (PSG) parameters, in patients suspected of OSA. Method Patients suspected of OSA who were scheduled for PSG were recruited. Cognition was assessed by the Montreal Cognitive Assessment (MoCA) and the Color Trails Test (CTT). The Memory index score (MIS) was also calculated from the MoCA. The presence of SCC was assessed by asking patients directly and using the Cognitive Change Index rated by self (CCI‐S) or informants (CCI‐I). Patients with severe dementia were excluded. Result Among 258 patients with an age of 61.46±7.05 years, 51.2% are female. The mean MoCA was 23.89±3.89. Based on PSG, patients were classified as having no OSA to mild OSA (20.1%), moderate (28.3%), and severe OSA (51.6%). Based on cognitive tests, patients with moderate to severe OSA had a higher proportion of objective cognitive impairment (64.1%) but less SCC (38.3%) than patients with no OSA or mild OSA. CCI‐S and CCI‐I scores were significantly correlated with each other (r = 0.238, p = 0.019) but not with MoCA score nor CTT‐time. Objective cognitive tests scores were associated with the number of comorbidities and several PSG parameters, i.e., total sleep time, sleep onset latency, wake after sleep onset, sleep stages, mean O2 saturation, and time spent of SaO2 under 90% (all p<0.05). Meanwhile, subjective cognitive scores were not associated with any PSG parameters. However, the self‐report (CCI‐S) was significantly correlated with the Thai‐Geriatric Depression Scale and the Epworth Sleepiness Scale (r = 0.388 and 0.262, respectively, p <0.001). Thirty patients with severe OSA and CI were followed‐up after CPAP treatment for the mean of 12.2 months and showed a significant improvement on MoCA and MIS scores, but not the CTT and CCI scores. Conclusion Most patients with OSA had objective cognitive impairment, but SCC was found less in a more severe stage of OSA. Several PSG parameters were associated with cognitive scores but not subjective cognitive scores. Patients with severe OSA could have a cognitive benefit after CPAP treatment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".