Treating Sleep Apnea Can Lower the Risk of Age-Related Dementia

By Admin

Recent studies have found that sleep apnea, a disorder with a high number of common comorbidities, is closely linked to age-related dementia such as Alzheimer’s disease and other forms of memory loss. As with other studies on sleep apnea and its related health effects, this new research has specifically highlighted the benefits of PAP therapy as a preventative measure, concluding that sleep apnea treatment may significantly reduce the risk of developing dementia. While a number of causal factors may be at work with this type of comorbid relationship, the research lends further support to a growing body of evidence linking CPAP with cognitive and other health benefits, not only as a preventative measure but also for reducing symptoms and improving quality of life. Dementia is a memory disorder that is closely related to sleep health and other mental functions, and Alzheimer’s disease is the most common form, affecting over 6 billion Americans in 2021. With sleep apnea affecting over 22 million, many of whom may be affected by dementia or related cognitive symptoms as well, it is a critical time for new and integrative approaches to these highly prevalent and debilitating conditions.

New Research

The most recent study on sleep apnea and dementia was conducted at the Michigan Medicine Sleep Disorders Centers and included over 50,000 representative patients with sleep apnea. While the patients were over 65 years old, a majority (62 percent) were under 75. The study followed the records of every patient to calculate the rate of dementia and other forms of cognitive impairment among CPAP users versus non CPAP users, and within three years a clear distinction emerged between the two groups. The data supported a negative correlation between sleep apnea treatment and cognitive decline, particularly with Alzheimer’s disease.

What makes this study noteworthy, aside from its size and scope, is that it focused specifically on the role of CPAP adherence as a limiting factor in dementia. Within the three-year period, those who used CPAP regularly were less likely to be diagnosed with dementia or experience other forms of cognitive impairment, compared to those who were non-adherent or never used CPAP. This detail is highly significant given the generally stagnant adherence rates for CPAP therapy over the last decade or more.

The study results also emphasize the importance of a more proactive approach to the prevention and treatment of both conditions. For example, more widespread sleep apnea screening and diagnosis, especially at middle age and beyond, can be used to address the disorder as well as any comorbid developments.

"If a causal pathway exists between OSA treatment and dementia risk,” principal investigator Tiffany Braley, M.D., states on the Michigan University Laboratory Blog, “diagnosis and effective treatment of OSA could play a key role in the cognitive health of older adults.” At least one previous study included this topic as a possible focus area for future research. Published in Sept. 2020 in the journal Laryngoscope, a study on the prevalence of Alzheimer’s disease among patient with obstructive sleep apnea (OSA) concluded that OSA could be used as a potential “modifiable target” for slowing or preventing the development of Alzheimer’s. This type of crossover treatment is an example of patient-centered or comprehensive care, treating conditions from a whole-health perspective that focuses on the best course of action for long-term health and well being. Both sleep apnea and dementia are highly prevalent conditions affecting millions of Americans, and both are in need of more tailored, personalized, and specialized approaches to treatment.

Dementia, Sleep, and Sleep Apnea

According to the Centers for Disease Control and Prevention, dementia is a general term for “a decline in mental ability severe enough to interfere with daily life,” and because it is a general term, its symptoms can vary widely from person to person. There are many different types of dementia, and Alzhemer’s disease is the most prevalent, accounting for 60-80 percent of dementia cases. Unlike dementia, Alzheimer’s is a specific disease caused by degenerative damage to brain cells that worsen over time.

Common symptoms of both dementia and Alzheimer’s disease include the following:

Problems with memory or attention (esp. short-term memory)
Problems with reasoning, judgment, or communication
Personality changes (including but not limited to temporary mood shifts)
Visual problems beyond typical age-related changes
Losing things (or problems keeping track of everyday items)

Examples of common dementia-related experiences:

Getting lost (esp. in a familiar neighborhood)
Forgetting familiar words or names
Forgetting old memories (as well as new ones)
Not being able to complete tasks
Forgetting plans/appointments

While cognitive difficulties are common with age, repeated episodes involving more than simple forgetfulness are signs of a potential dementia condition. Aside from Alzheimer's disease, other forms of dementia include Lewy body dementias (LBD), caused by abnormal protein deposits in the brain (neurons), dementia from Parkinson’s disease, which causes difficulties with thinking and reasoning, as well as disruptions in sensory-motor processing, and Huntington’s disease, which is caused by a defective gene. Another type called vascular dementia is extremely relevant for sleep-disordered breathing. Vascular dementia is a decline in cognition caused by conditions that block or reduce blood flow to the brain. Closely related to hypoxia of the brain caused by sleep apnea (nocturnal cerebral hypoxia), vascular dementia is one of many health problems associated with oxygen deficiency and respiratory health issues.

Proper sleep health is extremely critical for cognitive functioning and memory, and untreated sleep disorders such as sleep apnea can lead to brain damage that is very similar to the effect of Alzheimer’s disease over time. Treatment with CPAP has been shown to not only prevent these effects from sleep-disordered breathing, but also can reverse the damage when used regularly. In fact, studies have found these changes beginning as early as one month after initiating CPAP. This connection between sleep, sleep apnea, and progressive brain disorders is an important intersection for further study, especially during a global pandemic caused by a respiratory illness. A widespread health concern like COVID-19 puts additional stress on the body and mind, and people over 60 have been hit the hardest. These studies give hope to those struggling to stay healthy at a difficult time, especially for those in need of a treatment plan for both sleep apnea and dementia. With further study in these areas, we may one day achieve the goal of reducing the high rates of these all-too-common disorders and provide a better quality of life for American seniors.