Obstructive Sleep Apnea Risk is Associated with Cognitive Impairment After Controlling for mild TBI history: A Chronic Effects of Neurotrauma Consortium Study.

The contribution of sleep disturbance to persistent cognitive symptoms following a mild traumatic brain injury (mild TBI) remains unclear. Obstructive sleep apnea (OSA) is common in those with mild TBI, yet the relationship between OSA risk and cognitive performance in those with history of mild TBI has not been investigated. The current study examined the risk of OSA in 391 combat exposed, post-911 veterans and service members (median age= 37 years) enrolled in the Chronic Effects of Neurotrauma Consortium (CENC), and the association between OSA risk and cognitive performance. Participants included those with and without mild TBI (n = 326 and 65 respectively). When using clinical cut-offs, those with history of mild TBI were significantly more likely to be categorized as high risk for OSA (mTBI = 65% vs. no mTBI = 51%). Independent of TBI status and demographic variables, increased OSA risk was significantly associated with worse performance on measures of complex processing speed and executive functioning (WAIS IV Coding, Trailmaking Test B) and greater symptom burden. Thus, OSA, a modifiable behavioral health factor, may contribute to cognitive performance following mild TBI. Accordingly, OSA serves as a potential point of intervention to improve clinical and cognitive outcomes after injury.