The Risk for Obstructive Sleep Apnea and Cognitive Function of High School Student
Keywords:cognitive function, student, obesity, obstructive sleep apnea
AbstractObstructive sleep apnea (OSA) is a common sleep disorder characterized by recurrent partial and/or total upper airway obstruction during sleep resulting in hypoxemia and arousal. One of the risk factors for OSA is obesity which its prevalence increased in Indonesia. OSA has a negative effect on cognitive function broadly. This study was aimed to determine the association between risk for OSA and cognitive function in high school students with obesity at Sulthon Aulia Boarding School, Bekasi. The study used a cross-sectional design and a simple random sampling technique. Data were taken using the Berlin Questionnaire and the Montreal Cognitive Assessment Indonesia version (MoCA-Ina) Questionnaire. The sample size is 47 subjects with inclusion criteria had overweight or obese body mass index (BMI) and were willing to be the research subjects. Subjects with a history of head injury, smoking, drinking alcohol, and taking sedative drugs were excluded from the study. There were differences in BMI and neck circumference between high-risk subjects for OSA and low-risk subjects for OSA. The risk level for OSA was significantly associated with cognitive function (p = 0.001; OR =12.727). High-risk subjects for OSA are recommended to lose weight and perform a polysomnographic evaluation.
Anwar, S.H., Tursina, A., & Rosady, D.S. Hubungan indeks massa tubuh dan lingkar leher dengan kejadian obstructive sleep apnea pada strok iskemik. In: Proceedings Bandung Meeting on Global Medicine & Health. 2017. Vol. 1 No. 1. pp. 68-72, from: http://proceeding.unisba.ac.id/index.php/ BaMGMH/article/ view/922. [Accessed 17 December 2014].
Arli, B., Bilen, S., Titiz, A.P., Ulusoy, E.K., Mungan, S., Gurkas, E., et al. (2015). Comparison of cognitive functions between obstructive sleep apnea syndrome and simple snoring patients: OSAS may be a modifiable risk factor for cognitive decline. Applied Neuropsychology, 22(4), 282-286.
Atkeson, A. & Jelic, S. (2008). Mechanisms of endothelial dysfunction in obstructive sleep apnea. Vascular Health and Risk Management, 4(6), 1327-1335.
Bucks, R.S., Olaithe, M., Rosenzweig, I. & Morrell, M.J. (2017). reviewing the relationship between OSA and cognition: where do we go from here? Respirology, 22(7), 1253-1261.
Canessa, N., Castronovo. V., Cappa, S.F., Aloia, M.S., Marelli, S., Falini, A., et al. (2011). Obstructive sleep apnea: brain structural changes and neurocognitive function before and after treatment. Am J Respir Crit Care Med., 183, 1419-1426.
Daulatzai, M.A. (2012). Pathogenesis of cognitive dysfunction in patients with obstructive sleep apnea: a hypothesis with emphasis on the nucleus tractus solitarius. Sleep Disord., 1-18.
Durán-Cantolla, J., Almeida, G.Z., de Guereñu, O.V.D., Rotaeche, L.S., Alkhraisat, M.H., Carro, J.D., et al. (2017). Validation of a new domiciliary diagnosis device for automatic diagnosis of patients with clinical suspicion of OSA. Respirology, 22(2), 378-385.
Ferini-Strambi, L., Baietto, C., Di Gioia, M.R., Castaldi, P., Castronovo, C., Zucconi, M., et al. (2003). Cognitive dysfunction in patients with obstructive sleep apnea (OSA): partial reversibility after continuous positive airway pressure (CPAP). Brain Res Bull., 61, 87-92.
Gabbay IE, Lavie P. (2012). Age- and gender-related characteristics of obstructive sleep apnea. Sleep Breath, 16, 453-460.
Gunawan, P.Y., Haris, S., Octaviana, F. (2014). Prevalensi obstructive sleep apnea dengan kuesioner stop-bang dan risiko stroke pada populasi normal. Neurona, 30(4), 249-257.
Hollis, A.M., Duncanson, H., Kapust, L.R., Xi, P.M., & O’Connor, M.G. (2015). Validity of the mini-mental state examination and the montreal cognitive assessment in the prediction of driving test outcome. J Am Geriatr Soc., 63, 988-992.
Husein, N., Lumempouw, S., Ramli, Y., & Herqutanto. (2010). Uji validitas dan reliabilitas montreal cognitive assesment versi Indonesia (MoCA-lna) untuk skrining gangguan fungsi kognitif. Neurona, 27(4), 15-22.
Franklin, K.A., & Lindberg, E. (2015). Obstructive sleep apnea is a common disorder in the population- a review on the epidemiology of sleep apnea. J Thorac Dis, 7(8), 1311-1322.
Kawaguchi, Y., Fukumoto, S., Inaba, M., Koyama, H., Shoji, T., Shoji, S., et al. (2011). Different impacts of neck circumference and visceral obesity on the severity of obstructive sleep apnea syndrome. Obesity, 19(2), 276-282.
Kementrian Kesehatan Republik Indonesia. 2018. Hasil Utama Riskesdas, from: http://www.depkes.go.id/resources/download/info-terkini/ materi_ rakorpop_2018/ Hasil%20Riskesdas%202018.pdf [Accessed 4 April 2019].
Kerner, N.A., & Roose, S.P. (2016). Obstructive sleep apnea is linked to depression and cognitive impairment: evidence and potential mechanisms. Am J Geriatr Psychiatry, 24, 496-508.
Lim, D.C., & Pack, A.I. (2014). Obstructive sleep apnea and cognitive impairment: addressing the blood-brain barrier. Sleep Medicine Reviews, 18(1), 35-48.
Macey, P.M. (2012). Is brain injury in obstructive sleep apnea reversible? Sleep, 35(1), 9-10.
Mannarino, M.R., Di Filippo, F., & Pirro, M. (2012). Obstructive sleep apnea syndrome. Eur J Intern Med., 23, 586-593.
Narang, I., Al-Saleh, S., Amin, R., Propst, E.J., Bin-Hasan, S., Campisi, P., et al. (2018). Utility of neck, height, and tonsillar size to screen for obstructive sleep apnea among obese youth. Otolaryngol Neck Surg., 158, 745-751.
Netzer, N.C., Stoohs, R.A., Netzer, C.M., Clark, K., & Strohl, K.P. (1999). Using the Berlin questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med. 1999, 131, 485-491.
Patil, S.P., Schneider, H., Schwartz, A.R., & Smith, P.L. (2007). Adult obstructive sleep apnea: pathophysiology and diagnosis. Chest, 132, 325-337.
Schwartz, A.R., Patil, S.P., Laffan, A.M., Polotsky, V., Schneider, H., & Smith, P.L. (2008). Obesity and obstructive sleep apnea: pathogenic mechanisms and therapeutic approaches. Proc Am Thorac Soc., 5, 185-192.
Senaratna, C.V., Perret, J.L., Lodge, C.J., Lowe, A.J., Campbell, B.E., Matheson, M.C., et al. (2017). Prevalence of obstructive sleep apnea in the general population: a systematic review. Sleep Medicine Review, 34, 70-81.
Setyaningrum, S.D., Yunika, K., & Andhitara, Y. (2017). Hubungan fungsi kognitif dengan riwayat obstructive sleep apnea pada pasien pasca stroke iskemik di RSUP DR Kariadi. JKD, 6(2), 1237-1243.
Simpson, L., Hillman, D.R., Cooper, M.N., Kim, L.W., Hunter, M., Cullen, S., et al. (2013). High prevalence of undiagnosed obstructive sleep apnoea in the general population and methods for screening for representative controls. Sleep Breath, 17, 967-973.
Susanto, A.D., Yunus, F., Antariksa, B., Fitriani, F., Luthfi, A., & Harlivasari, A.D. (2016). Prevalensi obstructive sleep apnea berdasarkan kuesioner Berlin pada polisi lalu lintas di Jakarta Timur. J Respir Indo., 36, 67-72.
Thorpy, M.J., Broughton, R.J., Cohn, M.A., Czeisler, C.A, Dement, W.C., Ferber, R., et al. (2001). Obstructive sleep apnea syndrome. In: International classification of sleep disorders, editors. Diagnostic and coding manual. Westchester: American Academy of Sleep Medicine.
Wimms, A., Woehrle, H., Ketheeswaran, S., Ramanan, D., & Armitstead, J. (2016). Obstructive sleep apnea in women: specific issues and interventions. BioMed Research International, 1-9.
Wreksoatmodjo, B.R. (2016). Pengaruh aktivitas fisik terhadap fungsi kognitif lanjut usia di Jakarta. CDK-236, 41(1), 7-12.
Yusop, C.Y.C., Mohamad, I., Mohammad, W.M.Z.W., & Abdullah, B. (2017). Cognitive function among obstructive sleep apnea patients in North East Malaysia. J Natl Med Assoc., 109, 215-20.
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