{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:00:39Z","timestamp":1790622039460,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T00:00:00Z","timestamp":1780790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T00:00:00Z","timestamp":1780790400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100019210","name":"University Health Network Foundation","doi-asserted-by":"publisher","award":["G\u2010585005300860"],"award-info":[{"award-number":["G\u2010585005300860"]}],"id":[{"id":"10.13039\/100019210","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100003305","name":"ResMed Foundation","doi-asserted-by":"publisher","award":["G\u2010575225462760"],"award-info":[{"award-number":["G\u2010575225462760"]}],"id":[{"id":"10.13039\/100003305","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["FBD\u2010195197"],"award-info":[{"award-number":["FBD\u2010195197"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    The influence of coexisting obstructive sleep apnea (OSA) and cognitive impairment (CI) on perioperative outcomes is unclear, despite its potential clinical significance. We aimed to compare clinical outcomes between surgical patients with OSA or high risk OSA (OSA\/HR\u2010OSA) who have CI and those without CI. We assessed 655 surgical patients aged \u2265\u200965\u2009years. All participants completed the STOP or STOP\u2010Bang questionnaires to assess for risk of OSA and were classified as OSA\/HR\u2010OSA or No\u2010OSA\/LR\u2010OSA. To assess for probable CI, participants completed the in\u2010person or telephone Montreal Cognitive Assessment (MoCA) and were classified as CI or No\u2010CI. Among 655 participants, 377 (57.6%) had OSA\/HR\u2010OSA and 216 (33.0%) had CI. Twenty\u2010one percent (137\/655) presented with coexisting OSA\/HR\u2010OSA and CI. More participants in the OSA\/HR\u2010OSA group had CI compared to the No\u2010OSA\/LR\u2010OSA group (36.3% vs. 28.4%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.041). After adjustment, each additional year of education was associated with a 12% decrease in the odds of CI among participants with OSA\/HR\u2010OSA (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Participants with coexisting OSA\/HR\u2010OSA and CI had about 2\u2010fold higher odds for all\u2010cause complications (OR: 2.01, 95% CI: 1.29, 3.13,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.002) and 80% higher adverse composite outcomes (OR: 1.79, 95% CI: 1.16, 2.79,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.009) at 30\u2009days postoperatively than those with OSA\/HR\u2010OSA and No\u2010CI, after adjustment for covariates. In conclusion, coexisting OSA\/HR\u2010OSA and CI was common at 21% and associated with increased 30\u2010day all\u2010cause complications and composite outcomes. These findings emphasise the need for enhanced preoperative screening and multidisciplinary strategies to identify and manage such vulnerable patients.\n                  <\/jats:p>","DOI":"10.1111\/jsr.70390","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T05:46:01Z","timestamp":1780897561000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Obstructive Sleep Apnea and Cognitive Impairment: Implications for Surgical Outcomes"],"prefix":"10.1111","volume":"35","author":[{"given":"Yasmin","family":"Alhamdah","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Pain Management, Toronto Western Hospital University Health Network, University of Toronto  Toronto Ontario Canada"},{"name":"Institute of Medical Science Temerty Faculty of Medicine, University of Toronto  Toronto Ontario Canada"},{"name":"Krembil Brain Institute, Toronto Western Hospital University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellene","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Management, Toronto Western Hospital University Health Network, University of Toronto  Toronto Ontario Canada"},{"name":"Institute of Medical Science Temerty Faculty of Medicine, University of Toronto  Toronto Ontario Canada"},{"name":"Krembil Brain Institute, Toronto Western Hospital University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paras","family":"Kapoor","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Management, Toronto Western Hospital University Health Network, University of Toronto  Toronto Ontario Canada"},{"name":"Institute of Medical Science Temerty Faculty of Medicine, University of Toronto  Toronto Ontario Canada"},{"name":"Krembil Brain Institute, Toronto Western Hospital University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aparna","family":"Saripella","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Management, Toronto Western Hospital University Health Network, University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Butris","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Management, Toronto Western Hospital University Health Network, University of Toronto  Toronto Ontario Canada"},{"name":"Institute of Medical Science Temerty Faculty of Medicine, University of Toronto  Toronto Ontario Canada"},{"name":"Krembil Brain Institute, Toronto Western Hospital University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"He","sequence":"additional","affiliation":[{"name":"Institute of Medical Science Temerty Faculty of Medicine, University of Toronto  Toronto Ontario Canada"},{"name":"Department of Anesthesiology and Pain Medicine, Mount Sinai Hospital University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6774-8924","authenticated-orcid":false,"given":"Leif Erik","family":"Lovblom","sequence":"additional","affiliation":[{"name":"Biostatistics Department University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sazzadul","family":"Islam","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Management, Toronto Western Hospital University Health Network, University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Management, Toronto Western 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