Alharbi, Ahmad M;
Alotaibi, Nawal;
Uysal, Omer Faruk;
Rakhit, Roby D;
Brill, Simon E;
Hurst, John R;
Mandal, Swapna;
(2025)
Cognitive outcomes in chronic obstructive pulmonary disease (COPD)/OSA overlap syndrome compared to obstructive sleep apnea (OSA) alone: a systematic review.
Sleep and Breathing
, 29
(5)
, Article 275. 10.1007/s11325-025-03426-9.
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Abstract
Background: Obstructive Sleep Apnoea (OSA) and Chronic Obstructive Pulmonary Disease (COPD) are both independently associated with cognitive impairment. COPD/OSA overlap syndrome could potentially result in greater cognitive impairment that is more than additive. This systematic review evaluates attention, memory, executive function and global cognition in OSA alone compared to COPD/OSA overlap syndrome. Methods: Systematic searches in MEDLINE, EMBASE, PsycINFO, CINAHL, and CENTRAL identified studies assessing cognitive function in adults with OSA and/or COPD/OSA overlap syndrome. Inclusion criteria required validated diagnostic and cognitive assessment tools. Twelve studies, including 7,424 participants, were reviewed: 10 involving OSA alone and 2 involving overlap syndrome. A narrative synthesis was performed due to methodological heterogeneity. Registration number is: CRD42024557577. Results: OSA alone was primarily associated with mild to moderate cognitive impairment, with attention and executive function most affected, with nocturnal hypoxemia and sleep fragmentation thought to be underlying causative factors. Memory and global cognition were relatively preserved. In contrast, COPD/OSA overlap syndrome was associated with more severe impairments, particularly in memory and global cognition. Overlap patients had significantly lower cognitive scores and a higher prevalence of mild cognitive impairment compared to OSA alone. Conclusions: Whilst OSA alone is associated with mild to moderate cognitive impairments, COPD/OSA overlap syndrome associates with more pronounced impairments, particularly in memory and global cognition. Nocturnal hypoxemia and systemic inflammation may be important mechanisms. Early cognitive screening and targeted interventions could support clinicians in mitigating these risks.
| Type: | Article |
|---|---|
| Title: | Cognitive outcomes in chronic obstructive pulmonary disease (COPD)/OSA overlap syndrome compared to obstructive sleep apnea (OSA) alone: a systematic review |
| Location: | Germany |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1007/s11325-025-03426-9 |
| Publisher version: | https://doi.org/10.1007/s11325-025-03426-9 |
| Language: | English |
| Additional information: | This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Clinical Neurology, Respiratory System, Neurosciences & Neurology, OSA, COPD, Overlap syndrome, Cognitive function, Nocturnal hypoxemia, Systematic review, POSITIVE AIRWAY PRESSURE, IMPAIRMENT, DYSFUNCTION, DISORDERS, HYPOXEMIA, MORTALITY, MEMORY, OXYGEN, IMPACT, CPAP |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Respiratory Medicine |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10213875 |
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