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.