0672 Sleepiness, Psychomotor Vigilance and Cognition in People with OSA Adherent to PAP Therapy

Abstract Introduction Residual excessive daytime sleepiness (EDS) is common in people with obstructive sleep apnea (OSA) using positive airway pressure (PAP) regularly, and has been associated with reduced functional outcomes.We examined the association of EDS using the psychomotor vigilance test (PVT) and cognition in patients with OSA adherent to PAP. We hypothesized that objective sleepiness is associated with worse cognitive function. Methods This cross-sectional study included participants aged ≥40 years, from an academic sleep disorder center using PAP therapy for ≥6 months with a minimum use of 6 hours per night. Exclusions were diagnosis of dementia, cognitive impairment, stroke, and sleep disordersincluding narcolepsy, parasomnias and PMLD. Demographics, medical history, behavioral data including the Epworth Sleepiness Scale (ESS), were gathered through questionnaires and medical records.Cognitive data was collected using NeuroTrax™, assessing attention, executive function, memory, processing speed, and global cognition. Linear regression analyses were performed between cognitive domains and PVT outcomes (lapses ≥500ms and average reaction time (RT)). Results The cohort included 31 participants (71% Hispanic-Latino, 29% women) with mean age 61 (SD=8.95), and mean AHI 33.13 (SD=22.05). PVT data indicated an average RT of 404.30 ms and an average number of lapses (≥ 500 ms) at 8.20. Cognitive assessments revealed scores for global cognition (m= 103.25, SD=10.83), verbal memory (m= 97.76, SD= 12.50), executive function (m= 106.42, SD= 11.82), attention (m= 101.72, SD= 10.54), and information processing speed (m= 101.66, SD=21.05). Pearson’s test showed a correlation between lapses (≥ 500 ms) and memory (r = -0.44; p = 0.008), and average RT with age (r = 0.46; p = 0.006). No correlation was found between lapses (≥ 500 ms) and ESS (r = 0.21; p = 0.26) or average RT and ESS (r = 0.045; p = 0.81). Linear regression analysis, adjusting for age, showed an association between lapses with worse memory function (β= -0.86, p = 0.017), as well as average RT with worse information processing speed (β = -0.089, p = 0.049). Other cognitive domains were not associated with the PVT. Conclusion In people with OSA optimally adherent to PAP, objective sleepiness was associated with worse memory function and information processing speed. Support (if any)