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Impact of Obstructive Sleep Apnea on Cognitive and Motor Functions in Parkinson's Disease
Author(s) -
Elfil Mohamed,
Bahbah Eshak I.,
Attia Mahmoud M.,
Eldokmak Mohamed,
Koo Brian B.
Publication year - 2021
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.28412
Subject(s) - montreal cognitive assessment , obstructive sleep apnea , polysomnography , medicine , meta analysis , parkinson's disease , epworth sleepiness scale , comorbidity , physical therapy , sleep apnea , confidence interval , cognition , cohort study , disease , apnea , psychiatry , cognitive impairment
Parkinson's disease (PD) is a chronic neurodegenerative disorder that presents with motor and non‐motor manifestations. Amongst the non‐motor features, various forms of sleep disturbances can occur, and obstructive sleep apnea (OSA) is considered to be a common comorbidity. We conducted this systematic review and meta‐analysis to assess the impact of OSA on cognitive and motor functions in PD. Methods The information sources of for this systematic review and meta‐analysis were PubMed, SCOPUS, Web of Science, and ScienceDirect. Studies meeting the following criteria were included: (1) studies including idiopathic PD patients, (2) studies using polysomnography to categorize PD patients into PD with OSA and PD without OSA, and (3) studies with observational designs (case–control, cohort, or cross‐sectional). Data analysis was performed using RevMan. Results Our meta‐analysis showed that OSA was associated with significantly lower scores of Montreal Cognitive Assessments (MoCA) (mean difference (MD) = −0.70, 95% confidence interval (CI) [−1.28, −0.13], P = 0.01) and Mini‐Mental State Examination (MMSE) (MD = −0.69, 95% CI [−1.17, −0.21], P = 0.005). Moreover, the score of the motor part of the Unified Parkinson's Disease Rating Scale (UPDRS III) was significantly higher in PD patients with OSA as compared with those without OSA (MD = 1.63, 95% CI [0.03, 3.23], P = 0.049). Conclusions OSA is associated with increased severity of PD‐associated cognitive dysfunction and motor symptoms. However, further studies are needed to corroborate these findings, assess the underlying mechanisms by which OSA influences the motor and cognitive functions in PD, and investigate whether OSA can accelerate the neurodegenerative process of PD. © 2020 International Parkinson and Movement Disorder Society