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Volume 15 No. 03
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Accepted Papers

Scientific Investigations

Disconnection Between Self-Reported and Objective Cognitive Impairment in Obstructive Sleep Apnea

Katia Gagnon, BSc1,2; Andrée-Ann Baril, BSc1,3; Jacques Montplaisir, MD, PhD1,3; Julie Carrier, PhD1,4; Louis De Beaumont, PhD1,5; Caroline D'Aragon, BSc1; Sirin Chami, BSc1; Sandra Pelleieux, PhD6; Judes Poirier, PhD6,7; Serge Gauthier, MD8; Chantal Lafond, MD1; Jean-François Gagnon, PhD1,2; Nadia Gosselin, PhD1,4
1Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; 2Université du Québec à Montréal, Department of Psychology, Montreal, Quebec, Canada; 3Université de Montréal, Department of Psychiatry, Montreal, Quebec, Canada; 4Université de Montréal, Department of Psychology, Montreal, Quebec, Canada; 5Université de Montréal, Department of Surgery, Montreal, Quebec, Canada; 6Centre for Studies in Alzheimer's Disease Prevention, Douglas Institute, Montreal, Quebec, Canada; 7McGill University, Department of Psychiatry and Medicine, Montreal, Quebec, Canada; 8McGill University, Department of Psychiatry, Neurology and Neurosurgery, Montreal, Quebec, Canada

Study Objectives:

Recent studies show that obstructive sleep apnea (OSA) is a possible contributor to abnormal cognitive decline in older adults. These new observations create the need to identify older adults with OSA who are at risk of developing dementia if not treated. This study's goal was to verify whether self-reported cognitive complaints could become a useful tool to screen for objective cognitive deficits in late middle-aged and older adults with OSA.


Fifty-seven participants with OSA with an apnea-hypopnea index (AHI) ≥ 15 events/h (3% or arousal) and aged between 55 and 85 years were compared to 54 participants in a mild/non-OSA group on their ability to evaluate their objective cognitive functioning. They underwent overnight polysomnography followed by a comprehensive neuropsychological assessment. We recruited a similar proportion of participants with mild cognitive impairment (MCI) in both groups (OSA: 36.8%; mild/non-OSA: 35.2%). They filled out questionnaires assessing mood, sleep, and cognition. Group (OSA versus mild/non-OSA) × cognitive status (MCI versus non-MCI) analyses of variance were performed on cognitive complaint questionnaires.


We found that among participants without objective cognitive deficits, participants in the OSA group reported more cognitive complaints compared to those in the mild/non-OSA group. Among participants with objective cognitive deficits, those in the OSA group reported less cognitive complaints compared to those in the mild/non-OSA group.


Participants with OSA and MCI were less aware of their deficits compared to those in the mild/non-OSA group, possibly reflecting a distinctive OSA-associated cognitive impairment. Our results underscore the importance of referring patients with OSA for a comprehensive neuropsychological assessment when an abnormal cognitive decline is suspected.


Gagnon K, Baril AA, Montplaisir J, Carrier J, De Beaumont L, D'Aragon C, Chami S, Pelleieux S, Poirier J, Gauthier S, Lafond C, Gagnon JF, Gosselin N. Disconnection between self-reported and objective cognitive impairment in obstructive sleep apnea. J Clin Sleep Med. 2019;15(3):409–415.

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