1019 Obstructive Sleep Apnea and Cognitive Functioning 2 Years After Injury in Adults with Traumatic Brain Injury

Abstract Introduction Obstructive sleep apnea (OSA) is associated with structural and functional brain changes and reduced cognition. Persons with traumatic brain injury (TBI) show disproportionately higher risk of OSA compared to community samples. Moderate-to-severe TBI often results in disabling cognitive sequelae, although the impact of OSA on cognitive outcome after TBI is poorly understood. The purpose of this study was to examine the degree to which OSA features predict cognitive performance during early TBI recovery. We hypothesized that greater obstructions, oxygen saturation, and cortical arousals would predict poorer cognition. Methods This was a secondary analysis of participants co-enrolled in the TBI Model Systems (TBIMS) and Comparison of Sleep Apnea Screening and Diagnostic Tools (CSAS) studies. Participants underwent attended PSG while admitted for neurorehabilitation following moderate-to-severe TBI. Telephone follow-up interviews were conducted 2 years ± 3 months from injury date and included the Brief Test of Adult Cognition by Telephone (BTACT). Spearman correlations were calculated between PSG metrics and BTACT performance. Results Of 184 participants co-enrolled in the CSAS and TBIMS studies, 123 had valid BTACT data and compromised the analytical sample. There was a negative correlation between the total Apnea-Hypopnea Index (AHI) and the BTACT Executive Function composite (ρ=-0.189, p=0.040), working memory (ρ=-0.199, p=0.029), and reasoning (ρ=-0.192, p=0.035). Cortical arousals was negatively correlated with reasoning (ρ=0.211, p=0.021). Correlations between PSG metrics of oxygen desaturation (nadir, desaturation index, percent sleep time below 90% peripheral oxygen saturation) and BTACT performance were statistically nonsignificant. Conclusion This study provides evidence that PSG metrics of OSA are associated with decreased cognitive performance during early recovery from moderate-to-severe TBI. Future studies should examine the degree to which OSA treatment can ameliorate cognitive deficits following TBI. Support (if any) PCORI (CER-1511-33005), NIDILRR (90DPTB0007, 90DP0084, 90DPTB0013, 90DPTB0008, 90DPT80004, 90DPTB0001, 90DPTB0024), and DHA Contract HT0014-22-C-0016 (For information, contact dha.TBICOEinfo@health.mil. UNCLASSIFIED). Defined as U.S. Government work under Title 17 U.S.C.§101. Supported with resources and use of facilities at the James A Haley Veterans’ Hospital. Views presented are of the authors and do not necessarily represent official policy or position of any U.S. government agency.