Sleep Disorder Can Often Be Mistaken for Cognitive Slide

By the Editorial Team · Monday, October 12, 2026

Obstructive sleep apnea (OSA), a sleep disorder marked by repeated breathing interruptions, can cause cognitive problems in older adults without the typical symptom of daytime sleepiness. Recognizing OSA as a possible cause of memory and concentration issues is vital since timely treatment can enhance cognitive health and reduce related health risks.

As people age, occasional forgetfulness or difficulty concentrating is often seen as a normal part of getting older. However, these symptoms may sometimes indicate an underlying condition known as obstructive sleep apnea (OSA), which is frequently overlooked as a potential cause of cognitive decline in older adults.

Obstructive sleep apnea is characterized by repeated interruptions in breathing during sleep, sometimes occurring 30 or more times per hour in severe cases. These disruptions prevent restful sleep and commonly lead to excessive daytime sleepiness, prompting many individuals to seek medical advice. Nevertheless, for a subset of patients—particularly older adults—daytime sleepiness may not be a prominent symptom.

David Rapoport, an internist and director of research in integrative sleep medicine at the Icahn School of Medicine at Mount Sinai, explained that some people with OSA “just don’t seem to get as sleepy.” This atypical presentation can make the condition harder to detect in older populations since the usual warning sign of fatigue may be absent.

A 2026 review published in the journal Sleep Medicine Reviews highlights this issue, noting that individuals aged 65 and older with sleep apnea may experience minimal daytime drowsiness but instead manifest cognitive symptoms such as memory difficulties and problems with concentration. These symptoms can easily be mistaken for normal cognitive aging or other conditions, potentially delaying diagnosis and treatment of the underlying sleep disorder.

Experts emphasize the importance of considering obstructive sleep apnea as a possible explanation when older adults report cognitive changes. Early identification is crucial because untreated sleep apnea is associated with increased risks for cardiovascular disease, diabetes, and reduced quality of life. Moreover, treatment options such as continuous positive airway pressure (CPAP) therapy can improve both sleep quality and cognitive functioning.

Researchers continue to investigate the varying presentations of sleep apnea across different age groups and how best to screen for the disorder among older adults, who might not exhibit the classic symptom of daytime sleepiness. Awareness among healthcare providers and the public may help improve diagnosis and management of this potentially reversible cause of cognitive impairment.

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