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Canadian Journal of Anesthesia/Journal canadien d'anesthésie

Erschienen in:

18.08.2022 | Review Article/Brief Review

The potential link between obstructive sleep apnea and postoperative neurocognitive disorders: current knowledge and possible mechanisms

verfasst von: MD, PhD Michael J. Devinney, MD Keith W. VanDusen, MD Jad M. Kfouri, BS Pallavi Avasarala, MD Andrew R. Spector, MD, MHSc Joseph P. Mathew, MD, PhD Miles Berger

Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Ausgabe 10/2022

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Abstract

Purpose

This narrative review examines the current evidence on whether obstructive sleep apnea (OSA) is associated with postoperative delirium (POD) and postoperative cognitive dysfunction (POCD). The mechanisms that could predispose OSA patients to these disorders are also explored.

Source

Relevant literature was identified by searching for pertinent terms in Medline^®, Pubmed, Scopus^TM, and Google scholar databases. Case reports, abstracts, review articles, original research articles, and meta-analyses were reviewed. The bibliographies of retrieved sources were also searched to identify relevant papers.

Principal findings

Seven studies have investigated the association between OSA and POD, with mixed results. No studies have examined the potential link between OSA and POCD. If these relationships exist, they could be mediated by several mechanisms, including increased neuroinflammation, blood–brain barrier breakdown, cerebrovascular disease, Alzheimer’s disease neuropathology, disrupted cerebral autoregulation, sleep disruption, sympathovagal imbalance, and/or disrupted brain bioenergetics.

Conclusion

There is very limited evidence that OSA plays a role in postoperative neurocognitive disorders because few studies have been conducted in the perioperative setting. Additional perioperative prospective observational cohort studies and randomized controlled trials of sleep apnea treatment are needed. These investigations should also assess potential underlying mechanisms that could predispose patients with OSA to postoperative neurocognitive disorders. This review highlights the need for more research to improve postoperative neurocognitive outcomes for patients with OSA.

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Titel: The potential link between obstructive sleep apnea and postoperative neurocognitive disorders: current knowledge and possible mechanisms
verfasst von: MD, PhD Michael J. Devinney
MD Keith W. VanDusen
MD Jad M. Kfouri
BS Pallavi Avasarala
MD Andrew R. Spector
MD, MHSc Joseph P. Mathew
MD, PhD Miles Berger
Publikationsdatum: 18.08.2022
Verlag: Springer International Publishing
Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Ausgabe 10/2022
Print ISSN: 0832-610X
Elektronische ISSN: 1496-8975
DOI: https://doi.org/10.1007/s12630-022-02302-4

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20.03.2023 | Petechien | Nachrichten

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The potential link between obstructive sleep apnea and postoperative neurocognitive disorders: current knowledge and possible mechanisms

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