Detecting sleep‐related breathing disorders using overnight pulse oximetry in patients with dementia and mild cognitive impairment

Li, Haoxuan; Gabb, Victoria; Morrison, Hamish; Blackman, Jonathan; Biswas, Bijetri; Kendrick, Adrian; Coulthard, Elizabeth

Abstract

AbstractBackgroundSleep disturbance is commonly reported in Alzheimer’s disease (AD), Lewy body dementia (LBD) and mild cognitive impairment (MCI). Early identification of sleep changes is crucial as poor sleep could contribute to cognitive decline and worsen disease progression. Sleep‐related breathing disorders (SBD), including obstructive sleep apnoea, have been associated with dementia and its treatment using continuous positive airway pressure (CPAP) may improve cognitive trajectory (Osorio et al., 2015). The Remote Evaluation of Sleep To enhance understanding of Early Dementia (RESTED) study is an ongoing cohort study conducted at the University of Bristol, aiming to characterise sleep changes in early dementia using remote tools. Here, we outline preliminary data from a small group of RESTED participants undergoing overnight pulse oximetry to screen for SBD.MethodOlder adults with AD or MCI due to AD (AD‐MCI), LBD or MCI due to DLB/PD (LBD) and age‐matched healthy controls (HC) were recruited from memory clinics and volunteer databases at North Bristol NHS Trust. Participants completed baseline questionnaires including Epworth Sleepiness Scale (ESS) and STOP‐BANG, in addition to undergoing pulse oximetry testing on two consecutive nights at home. Parameters including oxygen desaturation index 3% (ODI3%) and pulse rise index were analysed. Those with suspected SBD were referred to tertiary sleep services. Mann‐Whitney test was conducted to investigate differences in ODI3% between ESS or STOP‐BANG classification cut‐offs.ResultsOvernight pulse oximetry was well‐tolerated across groups, with all participants completing at least one full night’s recording. Preliminary results demonstrated an abnormal ODI3% in eight of 13 participants (AD‐MCI n = 3/6, LBD n = 3/3, HC n = 2/4). Of the remaining 5, 2 (HC) were referred for further testing due to abnormal pulse rise index and 3 (AD‐MCI) did not demonstrate suspicion of SBD. No significant difference in ODI3% was found between ESS≤10 and >10 (p = 0.28) or STOP‐BANG<3 and ≥3 (p = 0.15).ConclusionOvernight pulse oximetry serves as an easy to use, objective method in screening for SBD, which could provide an additional avenue for targeting dementia risk. Routine screening may be implicated for older adults with cognitive impairment who may otherwise not be considered high risk for SBD, particularly in the absence of subjective daytime sleepiness.

• Presentation Conference Type: Poster
• Conference Name: Alzheimer’s Association International Conference
• Start Date: Jul 16, 2023
• End Date: Jul 20, 2023
• Deposit Date: Mar 12, 2024
• Publisher: Elsevier
• DOI: https://doi.org/10.1002/alz.073303
• Keywords: Psychiatry and Mental health, Cellular and Molecular Neuroscience, Geriatrics and Gerontology, Neurology (clinical), Developmental Neuroscience, Health Policy, Epidemiology
• Public URL: https://uwe-repository.worktribe.com/output/11651918