EEG patterns and cognitive outcomes in chronic respiratory disorders: a systematic review.

OBJECTIVE

To synthesize available evidence on electroencephalography (EEG) correlates of cognitive impairment in chronic respiratory disorders.

METHODS

This systematic review followed PRISMA guidelines and was preregistered on the Open Science Framework. PubMed/MEDLINE, Scopus, and Web of Science were searched through 14 March 2026. Eligible studies included adults with chronic respiratory disorders, EEG-based measures, and cognitive outcomes. Findings were synthesized narratively, and methodological quality was appraised using the Mixed Methods Appraisal Tool (MMAT), version 2018.

RESULTS

Forty-four studies met the inclusion criteria. Evidence was dominated by obstructive sleep apnea (OSA), with limited data on chronic obstructive pulmonary disease, asthma, and chronic respiratory failure/encephalopathy. Three recurrent patterns emerged: prolonged event-related latencies, especially P300 latency; alterations in sleep EEG microstructure, including spindle and slow-oscillation abnormalities; and resting-state EEG slowing. Across modalities, EEG abnormalities were most consistently associated with impairments in attention, executive functioning, working memory, memory consolidation, and broader cognitive efficiency.

CONCLUSIONS

EEG abnormalities are recurrent correlates of cognitive vulnerability in chronic respiratory disorders, particularly in OSA, although the evidence remains heterogeneous.

SIGNIFICANCE: EEG may offer clinically relevant markers of neurocognitive vulnerability in respiratory populations, but broader representation of non-OSA disorders and greater methodological standardization are needed.