21. Sleep and cognitive preservation

Mary Morrell.
London, UK


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Sleep disruption and cognitive impairment

A growing body of evidence suggests that sleep disruption, especially associated with Obstructive Sleep Apnoea (OSA), produces a consistent pattern of deficits in cognition, particularly in relation to attention, episodic memory, and executive function. However, explanations vary regarding how sleep disruption affects cognition, and reliable evidence is hard to find. This issue may relate to the many, common comorbid conditions that are present in patients with sleep disruption, especially older people, such as OSA. This presentation will review the evidence for cognitive impairment in sleep disruption, using OSA as a model, and focusing on the methodological and theoretical challenges of exploring the effect of sleep on cognition. To conclude, the presentation will review future directions for the field including suggestions of core design elements for future studies.

Where do we go from here? The number and type of studies exploring the extent to which sleep impacts on cognitive function is growing exponentially. Given the increasing prevalence of road traffic and work-place accidents, the large number of shift-workers, and the links between sleep disruption and cognitive dysfunction in older people, this focus is warranted. However, little is known about who is most at risk of cognitive impairment, and subsequent dementia. Defining who, why and how future studies can provide treatments to the most vulnerable individuals are important targets. It is hoped that the B-DEBATE will enable the field to focus on these questions and support the development of future researchSleep disruption and cognitive impairment.

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As a student, Professor Morrell developed an interest in the control of breathing during sleep which continues to drive her research at the National Heart and Lung Institute, Imperial College London.

Professor Morrell’s research focuses on the causes and consequences of sleep disordered breathing; particularly the impact of intermittent hypoxia on the brain. Her aim is to translate physiological research into improvements in patient care. Recently, she developed a UK respiratory-sleep network facilitating multi-center trials. The network has previously completed a trial to determine the impact of treating OSA in older people, and is currently investigating mild OSA. Mary has served on the American Thoracic Society Board of Directors, the Physiological Society Executive Board and she is a Past-President of the British Sleep Society.

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