The Impact of Poor Sleep and Snoring on Cognitive Function |

NEW DELHI: If you don’t sleep properly or have the habit of snoring with breath-holding spells during sleep, it is likely to affect your cognitive function.
A new study published in the journal Sleep and Breathing – which focuses on the science and practice of sleep medicine globally – both poor sleep quality and obstructive sleep apnoea (OSA) have a direct adverse impact on cognitive function in the middle-aged and elderly. Cognitive function refers to mental processes involved in the acquisition of knowledge, reasoning and manipulation of information.
According to the study by researchers at AIIMS Delhi, Erasmus Medical Center (Netherlands), Harvard T H Chan School of Public Health (USA), and Rajendra Institute of Medical Sciences, severe OSA symptoms significantly affect information processing speed and memory. Poor sleep quality, on the other hand, is negatively related to information processing speed and memory as well as executive functions.
The study states that around one in 10 people in India are affected by OSA, a disorder caused by repetitive collapse of the upper airway during sleep.
Dr Kameshwar Prasad, emeritus professor of neurology at AIIMS Delhi, who was part of the study, told TOI, “Adequate sleep and treatment for sleep-disordered breathing can reverse cognitive deficits caused by them.”
Periodic interruption in a person’s breathing, the study says, causes periods of hypoxia (absence of enough oxygen in the tissues to sustain bodily functions), which in turn can lead to several pathologic changes in the cerebral microvascular and neurovascular systems, including decreased blood flow (hypoperfusion), decreased function of the inner lining of blood vessels (endothelial dysfunction), and an increase in inflammation in the nervous system (neuroinflammation).
“The resulting oxidative stress and inflammation can result in damage to the brain tissues, and changes in brain structure, leading to a range of cognitive problems and the domains of vigilance, attention, reaction time, executive function, problem-solving, verbal recall, non-verbal recall, and episodic memory are particularly implicated therein,” it adds.
Dr Prasad said OSA is more common among people who are overweight and obese. “Those adults (especially obese) who have breath-holding spells during snoring should get properly evaluated and treated to avoid the adverse effects on memory and other brain functions. Also, good sleep quality is equally important for better cognitive function,” he said.
Dr Anant Mohan, head of pulmonology department at AIIMS, told TOI in a recent interview that there was an urgent need to increase awareness about sleep disorders, including OSA, among the public. “Similar to other lifestyle disorders like heart disease and diabetes, we also require public health measures and policy formulation for tackling OSA at a large scale in our population,” he said.
According to Dr J C Suri, a pioneer of critical care and sleep medicine in India, OSA is diagnosed when there are frequent pauses in breathing that prolongs for more than 10 seconds. “We do see patients who have pauses that are longer than a minute. It can be fatal,” he said.
Mild sleep apnoea can be corrected with lifestyle changes such as weight reduction and no alcohol. But those suffering from moderate and severe sleep apnoea need to be put on CPAP (continuous positive airway pressure) or Bi-PAP (bi-level positive airway pressure), doctors say.
A CPAP machine releases compressed air through a hose which is connected to the nose mask to keep the upper airway open. It maintains a constant air pressure throughout each breathing process. A Bi-PAP machine provides distinct air pressure levels for inhalation and exhalation. Some patients may also require surgery.

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