Sex differences in the association of sleep spindle density and cognitive performance among community‐dwelling middle‐aged and older adults with obstructive sleep apnea

Summary Recent studies have found associations between obstructive sleep apnea and cognitive decline. The underlying mechanisms are still unclear. Here, we investigate the associations between changes in micro‐architecture, specifically sleep spindles, and cognitive function in community‐dwelling middle‐aged and older adults, some with obstructive sleep apnea, with a focus on sex differences. A total of 125 voluntary participants (mean age 66.0 ± 6.4 years, 64 females) from a larger cohort (participants of the Brain in Motion Studies I and II) underwent 1 night of in‐home polysomnography and a neuropsychological battery (sleep and cognitive testing were conducted within 2 weeks of each other). A semi‐automatic computerized algorithm was used to score polysomnography data and detect spindle characteristics in non‐rapid eye movement Stages 2 and 3 in both frontal and central electrodes. Based on their apnea–hypopnea index, participants were divided into those with no obstructive sleep apnea (apnea–hypopnea index