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Canadian Journal of Anesthesia/Journal canadien d'anesthésie

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18-08-2022 | Sleep Apnea | Review Article/Brief Review

The potential link between obstructive sleep apnea and postoperative neurocognitive disorders: current knowledge and possible mechanisms

Authors: Michael J. Devinney, MD, PhD, Keith W. VanDusen, MD, Jad M. Kfouri, MD, Pallavi Avasarala, BS, Andrew R. Spector, MD, Joseph P. Mathew, MD, MHSc, Miles Berger, MD, PhD

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 10/2022

Abstract

Purpose

This narrative review examines the current evidence on whether obstructive sleep apnea (OSA) is associated with postoperative delirium (POD) and postoperative cognitive dysfunction (POCD). The mechanisms that could predispose OSA patients to these disorders are also explored.

Source

Relevant literature was identified by searching for pertinent terms in Medline^®, Pubmed, Scopus^TM, and Google scholar databases. Case reports, abstracts, review articles, original research articles, and meta-analyses were reviewed. The bibliographies of retrieved sources were also searched to identify relevant papers.

Principal findings

Seven studies have investigated the association between OSA and POD, with mixed results. No studies have examined the potential link between OSA and POCD. If these relationships exist, they could be mediated by several mechanisms, including increased neuroinflammation, blood–brain barrier breakdown, cerebrovascular disease, Alzheimer’s disease neuropathology, disrupted cerebral autoregulation, sleep disruption, sympathovagal imbalance, and/or disrupted brain bioenergetics.

Conclusion

There is very limited evidence that OSA plays a role in postoperative neurocognitive disorders because few studies have been conducted in the perioperative setting. Additional perioperative prospective observational cohort studies and randomized controlled trials of sleep apnea treatment are needed. These investigations should also assess potential underlying mechanisms that could predispose patients with OSA to postoperative neurocognitive disorders. This review highlights the need for more research to improve postoperative neurocognitive outcomes for patients with OSA.

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Title: The potential link between obstructive sleep apnea and postoperative neurocognitive disorders: current knowledge and possible mechanisms
Authors: Michael J. Devinney, MD, PhD
Keith W. VanDusen, MD
Jad M. Kfouri, MD
Pallavi Avasarala, BS
Andrew R. Spector, MD
Joseph P. Mathew, MD, MHSc
Miles Berger, MD, PhD
Publication date: 18-08-2022
Publisher: Springer International Publishing
Keywords: Sleep Apnea
Alzheimer's Disease
Alzheimer's Disease
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 10/2022
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI: https://doi.org/10.1007/s12630-022-02302-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The potential link between obstructive sleep apnea and postoperative neurocognitive disorders: current knowledge and possible mechanisms

Abstract

Purpose

Source

Principal findings

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Source

Principal findings

Conclusion

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