Sleep apnea linked to dementia

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Seattle Post

People who suffer from sleep apnea are at a high risk of developing memory problems and dementia as they get older, according to a recent study by the University of California, San Francisco and California Medical Center.

Sleeping disorders, and sleep apnea in particular, have long been associated with dementia, but this is the first time researchers have suggested that sleep problems may actually contribute to the development of cognitive impairment as we age.

For the study, a team of scientists followed almost 300 women in their early eighties for an average period of five years. At the outset, all participants tested normal in terms of cognitive abilities. The researchers found that the women who were diagnosed with sleep apnea were twice as likely to develop memory decline and other symptoms of dementia.

Although this particular study involved only women, there is no reason to believe that the results won’t apply to men as well. The disorder affects between 10 and 20 percent of middle-aged and older adults in the U.S., according to the Agency for Healthcare Research and Quality (AHRQ).

Sleep apnea causes sufferers to literally stop breathing while they’re asleep, sometimes hundreds of times a night. The reason is blockage of the airways. Consequently, blood oxygenation levels fall lower and lower until the body wakes up and normal breathing is resumed again – but only for a while. Typically, the person does not fully awake and is not aware that this is happening.

For their tests, the researchers looked at a number of specific factors connected with sleep apnea, including oxygen flow during sleep, duration of sleep and frequency of interruptions throughout the night. The risk of developing dementia appeared to be directly linked to the amount of time the women experienced a decrease of oxygen flow – not to the hours of sleep they had or the number of sleep interruptions they went through.

“The findings indicate that people with sleep apnea should be screened for cognitive problems,” said Dr. Kristine Yaffe, professor of psychiatry, neurology and epidemiology and lead author of the report that was published in the Journal of the American Medical Association (JAMA).

Although additional research is required, the study has already been acknowledged as an important step toward a better understanding of the seriousness of sleep apnea and the need for more effective treatment. “It makes sense that good sleep is going to be protective to the brain,” said Dr. Robert Thomas of Harvard Medical School in Boston, Massachusetts, who is an expert on the subject but was not involved in this study.

The most common way to treat sleep apnea is to force oxygen up a patient’s airways to prevent blockage with the help of a device that is placed in the mouth, a.k.a. Continuous Positive Airway Pressure (CPAP). Unfortunately, not everyone gets easily used to this procedure.

The disease affects often people who are overweight or have heart- and blood pressure problems. “There is only one cure for apnea so far we’ve found, and this is weight loss,” said Dr. Seva Polotsky, a researcher at Johns Hopkins University School of Medicine in Baltimore.

Aside from the issue of effective treatment, the study also gives rise to questions about the importance of sleep for both physical and mental health. The problem is that we don’t really understand yet what sleep does for us. “There is quite a broad consensus that supports the notion that memories are consolidated during sleep. But obviously the field is still not clear about what the mechanisms for memory formation are,” said Dr. Luis de Lecea, professor of psychiatry and behavioral sciences at Stanford University in California, who studies sleep disorders and their effects on memory and other brain functions in lab animals. “The new research shows a much more dramatic effect from sleep disorders than simple memory loss. Cognitive impairment is a whole different ballgame,” he added.

Of course, treating sleep apnea does not prevent all age-related decline of cognitive functions. But these latest results could change how the medical profession views the importance of sleep for both physical and mental health in general. The hope is that early diagnosis and effective treatment of chronic sleep disorders could at least help to slow down the spreading development of dementia as the average life expectancy continues to rise.

Timi Gustafson R.D. is a clinical dietitian and author of “The Healthy Diner –