Honors College

Document Type

Honors Thesis




Marie Hayes

Committee Members

Thane Fremouw, Clarissa Henry, Leonard Kass, Jordan LaBouff

Graduation Year

May 2020

Publication Date

Spring 5-2020


With approximately 20% of Americans affected by obstructive sleep apnea (OSA), and over 30% of sleep apneic patients non-compliant with the most common form of treatment, CPAP (Continuous Positive Airway Pressure), the proposed study looks to investigate the relationship between OSA, CPAP-compliance, and cognitive decline associated with many aging-related neurodegenerative diseases [1, 2]. Our group has performed in-home sleep studies using a patented, sensor mattress-sheet device, and standard actigraphy. Demographics including a questionnaire on OSA compliance and neurocognitive tests were administered to participants between 62 and 90 years of age. Cognitive decline meeting criteria for MCI (Mild Cognitive Impairment, the prodrome of Alzheimer’s Disease) were determined, and groups were made of comparison individuals (n=45) and MCI individuals (n=50). CPAP compliance in relationship to MCI diagnosis was examined. It was hypothesized that there would be a correlation between CPAPcompliance of OSA participants and increased cognitive functioning, compared to the CPAP noncompliant counterparts. The proposed mechanism consists of sleep disruption for the CPAP noncompliant group, which would cause chronic hypoxia and decreased restorative function of sleep in the brain and other organs during sleep. The results show that participants with OSA compared to those where were non-OSA were significantly more likely to have identifiable comorbid conditions: higher BMI (p=0.026), hypertension (p=0.003), hypercholesterolemia (p=0.035), diabetes (p=0.015), and current depressive symptoms (p=0.042). The OSA group was also more likely to be male than the non-OSA group, (p=0.016). Additionally, the OSA group was found to have more sleep impairments compared to non-OSA: higher PSQI sum composite score (p=0.02), higher PSQI daytime dysfunction score (p=0.02), and decrease in sleep quality duration (p=0.01). Lastly, the OSA group performed significantly worse on the neurocognitive BVMT-R recognition of false alarms compared to the non-OSA group (p=0.002). CPAPcompliance was also found to be significantly associated with less comorbid health conditions and many sleep quality assessments. CPAP noncompliance was associated with hypertension (p=0.006), more current depressive symptoms (p=0.035), and diabetes (p=0.025), compared to the CPAP-complaint group. The CPAP-compliant group was found to have many significant associations with sleep measures compared to the CPAP noncompliant group: increased sleep quality (p=0.03), decreased sleep disturbances (p=0.02), decreased daytime dysfunction (p=0.03), improved PSQI sum composite score (p=0.03), and increased habitual sleep efficiency (p=0.05). There were no conclusive results between CPAP-compliance and neurocognitive assessment.