Published on: December 1, 2016
by Women’s Brain Health Initiative:
What is Sleep Apnea?
Sleep apnea (AP-ne-ah) is a common disorder in which you have one or more pauses in your breathing or shallow breaths while you sleep.
Breathing pauses can last from a few seconds to minutes. They may occur 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.
Sleep apnea usually is a chronic (ongoing) condition that disrupts your sleep. When your breathing pauses or becomes shallow, you’ll often move out of deep sleep and into light sleep.
The Health Risks
Obstructive sleep apnea may primarily be considered a “man’s disease”, but it poses serious and even life-threatening health risks for women who suffer it as well – particularly those women who live with the condition undiagnosed. Besides daytime sleepiness and issues with concentration, sleep apnea in women can cause an irregular heartbeat and high blood pressure in addition to other serious health problems like an increased chance of stroke.
Are Women Affected in the Same Way as Men?
Research has shown that sleep apnea is quite common in older adults, affecting as many as 53 percent of men and 26 percent of women.
A 2013 study led by The University of California, Los Angeles (UCLA) suggests that women are less likely than men to be diagnosed with obstructive sleep apnea. The study also found evidence that women with sleep
apnea are more profoundly affected in the areas of the brain that regulate mood and decision-making.
When it comes to obstructive sleep apnea, men and women often experience varying symptoms. While men often report symptoms such as snoring, waking up gasping for air or snorting, many women report symptoms like fatigue, anxiety and depression. Of course, some women also experience shortness of breath and snoring too, but, in many cases, the telltale signs of sleep apnea in females may not be as obvious.
The fact that men are twice as likely than women to be diagnosed with sleep apnea may be partially attributed to how women describe their symptoms. Sleep apnea in women is commonly mistaken for depression, hypertension, hypochondria or other disorders.
Is There A Connection Between Dementia and Sleep Apnea?
Ricardo Osorio, MD, Research Assistant Professor of Psychiatry at NYU Center for Brain Health in New York, and his colleagues studied 2,000 people enrolled in the Alzheimer’s Disease Neuroimaging Initiative (ADNI)—a population of 55 to 75 year olds, some of whom are cognitively normal, some who have mild cognitive impairment and others who have Alzheimer’s dementia. Everyone was asked about their snoring or sleep apnea, and researchers followed up every six months for two to three years to record any changes in their cognitive status.
Those who reported having sleep apnea or snoring tended to develop signs of mild cognitive impairment, including memory lapses and slower speed on cognitive skills, about 12 years earlier on average than those who didn’t report any sleep-disordered breathing. Mild cognitive impairment (MCI) often precedes Alzheimer’s dementia, but not all people who develop MCI go on to get Alzheimer’s. The connection between disrupted sleep breathing and MCI remained strong even after Osorio accounted for the effects of Alzheimer’s
-related genes, gender, education, depression and heart disease risk factors, all of which have been associated with increased risk of cognitive decline.
Osorio also saw a connection between sleep apnea or snoring and Alzheimer’s dementia, but it wasn’t as robust as the link to MCI. That might be because other studies have found that not only are sleep disorders a risk factor for Alzheimer’s, but they are also a symptom of the degenerative brain disease—so those who already developed Alzheimer’s disease may not have been accurately reporting their sleep habits.
In another study published in the journal Neurology, Dr. Andrew Varga, an instructor in medicine at the New York University Sleep Disorder Centre and study co-author, said “This study is adding to the emerging story that sleep apnea may be contributing in some way to the acceleration of cognitive decline as you age.”
Varga and his colleagues reviewed the medical histories of 2,470 people aged 55 to 90 who had participated in an earlier study designed to look for markers of Alzheimer’s disease.
At the outset, study volunteers were categorized as being free of memory and thinking problems, or in the early stages of mild cognitive impairment, or with Alzheimer’s disease.
The researchers found that sleep apnea was associated with a much quicker decline in cognitive function. But there was some good news from the study. Treatment for breathing problems during sleep appears to be protective, delaying the onset of MCI by approximately 10 years.
Patients with sleep apnea were, on average, diagnosed with mild cognitive impairment (MCI) nearly 10 years earlier than those who did not suffer from breathing problems during their slumber, according to New York University researchers.
The timespan for developing Alzheimer’s also seemed to speed up. Those with sleep apnea were diagnosed, on average, five years sooner than sound sleepers, the authors reported.
“Essentially, this meant that people who got treated declined at the same speed as people who didn’t have apnea at all,” Varga said. The treatment can include machines that help people breath better as they sleep.
Are there any options?
Osorio is careful not to implicate all snoring as a precursor to memory problems or Alzheimer’s. But particularly in the elderly, he says doctors should consider the potential effect that disrupted
breathing during sleep can have on the brain. While it’s not clear how sleep disorders might be increasing the risk of MCI or Alzheimer’s, it’s possible that the cumulate effects of even the short periods when the person isn’t breathing could deprive brain neurons of critical oxygen, and Alzheimer’s has been linked to slower or abnormal blood flow caused by hypertension and high cholesterol levels.
Other studies have also shown that the protein associated with Alzheimer’s, amyloid, tends to build up during the day when the nerves are active and decline at night during deep sleep. If people are being roused from deep sleep by their apnea or snoring, then they aren’t enjoying prolonged periods of low amyloid production, so the substance can build up and potentially form plaques.
Osorio also found that it’s possible to counteract some of the effects of sleep apnea. He also studied people who used a device to prevent apnea, known as a continuous positive airway pressure (CPAP) machine, which keeps airways open during sleep. Even though they snored or had sleep apnea, people who used the device developed MCI or Alzheimer’s at the same rate as those who didn’t have these sleep problems. CPAP machines are cumbersome and uncomfortable to use, and many people drop them after a few weeks. But, says Osorio, they may have more reason to stick with them now. “A lot of people don’t use them because they see no benefits,” he says, “but if they know it can improve their memory, they may definitely try to do better.”
Source: MIND OVER MATTER
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