# Cognition After OSA Treatment Among Native American People

> **NIH NIH P01** · WASHINGTON STATE UNIVERSITY · 2022 · $413,227

## Abstract

RESEARCH PROJECT 3: ABSTRACT
Prevalence of obstructive sleep apnea (OSA) among older adults in the US is as high as 56%. Short-term
neurological consequences of OSA include cognitive changes such as poor attention and impaired executive
function, although the mechanisms for these associations are unclear. OSA also increases risk of Alzheimer’s
disease and related dementias (ADRD) and mild cognitive impairment, as well as alters ADRD biomarkers.
Positive airway pressure is the gold standard treatment for OSA and improves cognition in clinical trials,
including patients with ADRD. Although American Indians have a high prevalence of obesity, a risk factor for
both OSA and ADRD, no reliable population-based estimates of OSA prevalence exist for AIs. OSA also is
likely underdiagnosed in American Indians, and data strongly suggest a disparity in this modifiable ADRD risk
factor. Accordingly, we will generate population-based estimates of OSA prevalence and its association with
cognitive function, develop a novel intervention, and conduct a randomized pragmatic trial. For the
epidemiology component, we will recruit members of 2 studies affiliated with the Strong Heart Study, the only
population-based study of cardiovascular and cerebrovascular disease in American Indians. We will screen
450 cohort members ages 55+ living on 2 Northern Plains reservations for OSA and measure cognitive
function. Participants with suspected OSA will undergo testing with the WATCHPAT, an FDA-approved sleep
apnea diagnostic device. Participants whose results confirm OSA will be referred for positive airway pressure
therapy and be eligible for the trial. Analyses will leverage previously collected data to identify fixed and time-
varying risk factors for OSA. Next, we will develop the behavioral intervention by using qualitative methods to
revise existing protocols for motivational interviewing and electronic messaging to increase pressure treatment
adherence. For the randomized controlled trial, we will recruit 300 American Indians ages 55+ from the
same Strong Heart Study communities who receive positive airway pressure treatment for OSA. They will be
randomized to receive usual care, or usual care plus the intervention. Data collection at baseline, 3 months
and 12 months will include positive airway pressure adherence, sleep quality, cognitive function, and vascular
risk factors for ADRD. Primary outcomes are positive airway pressure adherence and cognitive function, with
the former evaluated as a mechanistic explanation for change in the latter. Our Specific Aims are to: 1)
Estimate the prevalence of OSA and its association with cognitive function in older American Indians, and
identify OSA risk factors from existing longitudinal data collected by the 2 Strong Heart-Study-affiliated studies;
2) Develop the behavioral intervention and test its effect on positive airway pressure adherence and sleep
quality; and 3) Assess the intervention’s effectiveness on cognitive functio...

## Key facts

- **NIH application ID:** 10459243
- **Project number:** 5P01AG066584-02
- **Recipient organization:** WASHINGTON STATE UNIVERSITY
- **Principal Investigator:** KA'IMI ALOHILANI SINCLAIR
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $413,227
- **Award type:** 5
- **Project period:** 2021-08-01 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10459243

## Citation

> US National Institutes of Health, RePORTER application 10459243, Cognition After OSA Treatment Among Native American People (5P01AG066584-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10459243. Licensed CC0.

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