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Impact of Obstructive Sleep Apnea on Cognitive and Motor Functions in Parkinson’s Disease Patients

M. Elfil, E. Bahbah, M. Eldokmak, M. Attia, B. Koo (New Haven, CT, USA)

Meeting: MDS Virtual Congress 2020

Abstract Number: 395

Keywords: Cognitive dysfunction, Parkinsonism, Sleep disorders. See also Restless legs syndrome: Anatomy

Category: Parkinson's Disease: Cognitive functions

Objective: We conducted this systematic review and meta-analysis to assess the impact of OSA on cognitive and motor disorders in PD patients.

Background: Parkinson’s disease (PD) is a chronic progressive neurodegenerative disease, with an approximate prevalence of 1% in people above the age of 60. PD is characterized by both motor and non-motor manifestations, which occur due to the loss of dopaminergic and non-dopaminergic neurons, respectively. Sleep problems in PD include insomnia, excessive daytime sleepiness, rapid eye movement behavioral disorder (RBD), restless legs syndrome (RLS), and obstructive sleep apnea (OSA). Growing evidence supports that OSA significantly influences motor and non-motor functions in PD patients, but this issue has not been fully quantified.

Method: We searched PubMed, Scopus, Web of Science, and Cochrane Library for relevant observational studies comparing PD patients with OSA to PD patients without OSA in terms of cognitive and motor functions. Data were pooled as mean difference (MD with the corresponding 95% confidence intervals (CIs). Fixed and random-effects models were used to pool the results.

Results: Twelve observational studies were included in the analysis. Meta-analysis showed that the PD+OSA group was associated with higher Overall-Unified Parkinson’s disease rating scale (UDPRS) (MD= 4.83, 95% CI [1.31, 8.35], p=0.007, n= 218 patients) and UDPRS III (MD= 2.32, 95% CI [0.72, 3.93], p=0.005, n= 913 patients). In terms of Mini-mental state examinations (MMSE) and Montreal Cognitive Assessment (MoCA), patients with PD+OSA showed a significant reduction (MD= -0.66, 95% CI [-1.07, -0.25], p=0.001, n=641 patients) and (MD= -0.82, 95% CI [-1.37, -0.27], p= 0.003, n= 555 patients), respectively. Pooled data were homogenous.

Conclusion: Current evidence suggests that OSA signifіcantly worsens the cognitive and motor functions of PD patients. Therefore, we suggest early recognition of the presence of OSA and managing it properly as soon as possible, especially in patients with high risk.

To cite this abstract in AMA style:

M. Elfil, E. Bahbah, M. Eldokmak, M. Attia, B. Koo. Impact of Obstructive Sleep Apnea on Cognitive and Motor Functions in Parkinson’s Disease Patients [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/impact-of-obstructive-sleep-apnea-on-cognitive-and-motor-functions-in-parkinsons-disease-patients/. Accessed June 15, 2025.
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