Symptoms of obstructive sleep apnea are associated with less frequent exercise and worse subjective cognitive function across adulthood

Miranda G Chappel-Farley; Bryce A Mander; Ariel B Neikrug; Annamarie Stehli; Bin Nan; Joshua D Grill; Michael A Yassa; Ruth M Benca

doi:10.1093/sleep/zsab240

Symptoms of obstructive sleep apnea are associated with less frequent exercise and worse subjective cognitive function across adulthood

Sleep. 2022 Mar 14;45(3):zsab240. doi: 10.1093/sleep/zsab240.

Authors

Miranda G Chappel-Farley^{1

2}, Bryce A Mander^{2

3

4

5}, Ariel B Neikrug³, Annamarie Stehli³, Bin Nan^{2

4

6}, Joshua D Grill^{1

3

4}, Michael A Yassa^{1

2

3

4}, Ruth M Benca^{1

2

3

4

7}

Affiliations

¹ Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, USA.
² Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, USA.
³ Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA.
⁴ Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA.
⁵ Department of Cognitive Sciences, University of California Irvine, Irvine, CA, USA.
⁶ Department of Statistics, University of California, Irvine, Irvine, CA, USA.
⁷ Department of Psychiatry and Behavioral Medicine, Wake Forest University, Winston-Salem, NC, USA.

Abstract

Study objectives: To determine whether subjective measures of exercise and sleep are associated with cognitive complaints and whether exercise effects are mediated by sleep.

Methods: This study analyzed questionnaire data from adults (18-89) enrolled in a recruitment registry. The Cognitive Function Instrument (CFI) assessed cognitive complaints. Medical Outcomes Study Sleep Scale (MOS-SS) subscales and factor scores assessed sleep quality, daytime sleepiness, nighttime disturbance, and insomnia and obstructive sleep apnea (OSA)-like symptoms. Exercise frequency was defined as the weekly number of exercise sessions. Exercise frequency, MOS-SS subscales, and factor scores were examined as predictors of CFI score, adjusting for age, body mass index, education, sex, cancer diagnosis, antidepressant usage, psychiatric conditions, and medical comorbidities. Analyses of covariance examined the relationship between sleep duration groups (short, mid-range, and long) and CFI score, adjusting for covariates. Mediation by sleep in the exercise-CFI score relationship was tested.

Results: Data from 2106 adults were analyzed. Exercise and MOS-SS subscales and factor scores were associated with CFI score. Higher Sleep Adequacy scores were associated with fewer cognitive complaints, whereas higher Sleep Somnolence, Sleep Disturbance, Sleep Problems Index I, Sleep Problems Index II, and factor scores were associated with more cognitive complaints. MOS-SS subscales and factor scores, except Sleep Disturbance and the insomnia factor score, mediated the association between exercise and cognitive complaints.

Conclusions: The relationship between exercise frequency and subjective cognitive performance is mediated by sleep. In particular, the mediation effect appears to be driven by symptoms possibly suggestive of OSA which are negatively associated with exercise engagement, sleep quality, daytime sleepiness, and subjective cognitive performance.

Keywords: aging; cognitive complaints; exercise; insomnia; obstructive sleep apnea; sleep; subjective cognitive function.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Cognition
Disorders of Excessive Somnolence*
Humans
Sleep Apnea, Obstructive*
Sleep Initiation and Maintenance Disorders* / complications
Sleepiness
Surveys and Questionnaires

Abstract

Publication types

MeSH terms

Grants and funding