Sleep Apnea May Cause Dementia

Findings published in the Journal of the American Medical Association showed what sleep specialist have long suspected, that sleep apnea can deprive the brain and other organs of the oxygen they need. Over time this triggers a decline in cognitive ability.

"This is the first study to show that sleep apnea may lead to cognitive impairment," said study leader Kristine Yaffe, MD, professor of psychiatry, neurology and epidemiology at UCSF. "It suggests that there is a biological connection between sleep and cognition and also suggests that treatment of sleep apnea might help prevent or delay the onset of dementia in older adults."

The UCSF study had 298 subjects that began without dementia or a decline in cognitive abilities, which allowed the researchers to measure the relationship between sleep apnea and record the progress of individual’s cognitive skills.

Using sophisticated computerized data researchers were able to monitor brain activity, oxygen concentration, heart rhythm and airflow. The instruments allowed the researchers to monitor apneas or hypopneas (reduction of airflow) of 30 percent or more.

After compiling data from the participants, Yaffe and her colleges found that about one third of all the women developed dementia or mild cognitive impairment. Researchers found that women with sleep apnea had twice the likelihood of becoming cognitively impaired.

The findings suggest that the key factor leading to diminished cognition was oxygen deprivation, also called hypoxia. Women who had frequent episodes of low oxygen or spent a large portion of their sleep time in a state of hypoxia were more likely to develop cognitive impairment. By contrast, no independent connection was seen between dementia and the number of times patients were awakened in their struggle to breathe.

The most effective treatment for the nighttime breathing disorder known as obstructive sleep apnea is the continuous positive airway pressure (CPAP) machine, according to a new report by U.S. Agency for Healthcare Research and Quality (AHRQ)

A CPAP machine pumps air through a mask while the patient sleeps. This treatment is highly effective in improving sleep and reducing symptoms of obstructive sleep apnea, according to the review of available evidence.

The report also found that one other treatment — a mouthpiece called a mandibular advancement device (MAD) — can be highly effective for sleep apnea patients. The device moves the jaw forward and keeps the airway open.

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