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Journal Article Epublish 3 citations

PubMed: 40672996 DOI: 10.2147/NSS.S524831

Association Between Fractional Exhaled Nitric Oxide (FeNO) and Cognitive Function in Patients with Obstructive Sleep Apnea.

Nat Sci Sleep 17:1603-1614

Authors: Qilin Zhu, Lili Huang, Licheng Zhu, Xiaobai Zhang, Honghua Ji, Donghua Niu, Wangfei Ji, Qingqing Ma, Rong Chen, Haiyan Shi, Yihua Wang, Lina Xu

Affiliations

  • Department of Respiratory and Critical Care Medicine, Affiliated Nantong Hospital 3 of Nantong University & Nantong Third People's Hospital, Nantong, Jiangsu, 226000, People's Republic of China.
  • Biological Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, SO17 1BJ, UK.
  • Institute for Life Sciences, University of Southampton, Southampton, SO17 1BJ, UK.
  • NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, SO16 6YD, UK.

Abstract

Purpose

Obstructive sleep apnea (OSA) is characterised by intermittent hypoxia and sleep fragmentation, both of which can impair cognition. This study aimed to investigate the association between fractional exhaled nitric oxide (FeNO), a non-invasive marker of airway inflammation, and memory performance in patients with OSA.

Methods

A total of 102 participants were enrolled: 62 with moderate or severe OSA (apnea-hypopnea index, AHI≥15) and 40 with snoring or mild OSA (AHI <15). Memory was assessed with the Rey-Osterrieth Complex Figure Test (RCFT), Digit Ordering Test (DOT), and Logical Memory Test (LMT). FeNO was measured at 50mL/s (FeNO 50) and 200mL/s (FeNO 200); alveolar NO (CaNO) was calculated. Group comparisions used t-tests and chi-square tests, cognitive scores employed mixed-design ANOVA, and associations were examined with Spearman correlation plus hierarchical regression.

Results

Compared with the snoring or mild OSA group, participants with moderate or severe OSA had larger neck circumference, higher body-mass index, greater daytime sleepiness, and elevated FeNO 50 and FeNO 200 (P < 0.05). They also showed poorer immediate and delayed visual memory (both P< 0.05), which correlated negatively with AHI (r = -0.088/-0.103, P < 0.05) and FeNO 50 (r = -0.286/-0.302, P < 0.05). RCFT scores fell over time (F = 271.171, P < 0.05), with a significant group × time interaction (F = 3.065, P < 0.05). FeNO 50 independently predicted poorer immediate recall (β = -0.28, P = 0.018), whereas FeNO 200 was not significant.

Conclusion

Moderate or severe OSA is associated with impaired immediate and delayed visual memory. Higher FeNO 50 correlates with memory decline, supporting a link between airway inflammation and cognitive dysfunction in OSA.

MeSH

Sleep Apnea, Obstructive, Sleep, Apnea, Polysomnography, Snoring, Sleep Apnea Syndromes, Memory, Cognition