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Objectives: Autobiographical memory dysfunction is a marker of vulnerability to depression. Patients with obstructive sleep apnea (OSA) experience high rates of depression and memory impairment, and autobiographical memory impairments have been observed compared to healthy controls; however, these groups were not age-matched. This study aimed to determine whether individuals with untreated OSA have impaired autobiographical memory when compared to age-matched controls, and to assess the quality of autobiographical memories from three broad time points. Methods: A total of 44 participants with OSA (M age=49.4±13.0) and 44 age-matched controls (M age=50.0±13.1) completed the Autobiographical Memory Interview (AMI) to assess semantic and episodic memories from three different life stages, and 44 OSA participants and 37 controls completed the Autobiographical Memory Test (AMT) to assess overgeneral memory recall (an inability to retrieve specific memories). Results: OSA participants had significantly poorer semantic recall of early adult life on the AMI (p<.001), and more overgeneral autobiographical memories recalled on the AMT (=.001), than controls. Poor semantic recall from early adult life was significantly correlated with more depressive symptoms (p=0.006) and lower education (p<0.02), while higher overgeneral memory recall was significantly associated with older age (p=.001). Conclusions: A specific deficit in semantic autobiographical recall was observed in individuals with OSA. OSA patients recalled more overgeneral memories, suggesting that aspects of the sleep disorder affect their ability to recollect specific details of events from their life. These cognitive features of OSA may contribute to the high incidence of depression in this population. (JINS 2019, 25, 266–274)
This chapter discusses the three domains of cognition for which the effects of sleepiness are reasonably well understood: attention and vigilance, executive functioning, and learning and memory. It investigates the effects of sleepiness on distinct cognitive processes involved in the performance of cognitive tasks. Sleepiness due to sleep loss or circadian misalignment causes an increase of average reaction times in vigilance and reaction time tasks. Sleepiness has the potential to alter emotional states and bias the interpretation of the emotional context of a situation, and may thereby influence decision-making. Memory encoding, or the conversion of sensory input into a neural representation, appears to be adversely affected by lack of prior sleep. Sleepiness may affect these cognitive processes differentially, so that the effects of sleepiness depend on the ensemble of cognitive processes required to perform the task at hand.