EEG spectral analysis of nighttime sleep and daytime MSLTs and neurocognitive evaluations in obstructive sleep apnea patients with residual sleepiness

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ID: 327457
2026
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Abstract
Abstract Study objectives To explore neurophysiological and neurocognitive characteristics of OSA patients with residual excessive sleepiness (RES) using EEG spectral analysis and multidimensional cognitive assessments. Methods This case-control study included 76 participants (38 RES, 38 Non-RES) from our RES cohort. Polysomnography (PSG) and multiple sleep latency tests (MSLTs) were recorded and used to obtain relative EEG spectral power. A series of standard neurocognitive assessments were conducted during the first MSLT interval (approximately 09:00-11:00 AM). Results In PSG and MSLTs, RES patients showed increased delta and theta power and decreased alpha and beta power (all FDR-adjusted q<0.05). RES patients demonstrated multidimensional cognitive impairments, including longer WCST reaction time (mean difference [MD] = −642.71 ms, 95% CI: −1045.70 to −239.72, p = 0.002, partial η2 = 0.130), longer SCWT color-word reaction time (MD = −16.02 s, 95% CI: −25.32 to −6.71, p = 0.001, partial η2 = 0.148), and more PVT lapses (MD = −3.65, 95% CI: −5.28 to −2.03, p < 0.001, partial η2 = 0.228). The EEG spectral patterns of increased delta-theta power and decreased alpha-beta power were significantly associated with impairments in executive function, processing speed, working memory and selective attention, while the decreased alpha-beta power was more related to impairment of vigilance and sustained attention. Conclusions RES patients exhibit a characteristic EEG power spectrum marked by increased delta-theta and decreased alpha-beta power values, indicating sleep-wake dysregulation. RES patients also demonstrate multidimensional cognitive impairments, including deficits in processing speed, working memory, attention, and executive function, with distinct neurophysiological correlates.
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Authors
Journal Sleep & breathing = Schlaf & Atmung
Year 2026
DOI
10.1093/sleep/zsag241
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