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Sleep Apnea Dementia

August 10, 2011 by staff 

Sleep Apnea DementiaSleep Apnea Dementia, Older women who suffer from sleep apnea have a higher risk of developing mild cognitive impairment or dementia, new research shows.
The study found that older women who started the study without dementia had a probability greater than 85 percent develop mild cognitive impairment or dementia over the next five years if they had 15 or more episodes of apnea per hour of sleep.

“This was a prospective study of older women followed over time to understand the relationship between sleep apnea and cognitive impairment or dementia,” said study co-author Dr. Susan Redline, a researcher in the Division of Sleep Medicine Brigham and Women’s Hospital in Boston.

“We found a high prevalence of untreated sleep apnea – about one third of the women had sleep apnea, and women were about 80 percent higher risk of developing cognitive impairment or dementia during the study,” said Redline .

Although this study was not designed to discover the mechanism by which repeated lack of oxygen can cause dementia, Redline said it can harm the brain, affecting how the brain constantly renews its cells. We need more research done to find the exact mechanism, he added.

The findings are published in the August 10 edition of the Journal of the American Medical Association.

The study included 298 women without dementia at baseline. The average age of women was about 82. All women underwent a sleep study at night using sensors and computer monitoring (PSG) between 2002 and 2004.

A total of five women were diagnosed with sleep-disordered breathing. That meant they had 15 or more episodes of apnea per hour of sleep. During these episodes, the brain was temporarily deprived of oxygen.

Five years after the sleep study, women underwent cognitive function tests to assess their state of health of the brain. When the researchers compared brain health of women with sleep-disordered breathing and oxygen deprivation to women who did not, found that sleep-disordered breathing significantly increased the risk of mild cognitive impairment and dementia.

The researchers also adjusted the data to take into account other factors that may contribute to cognitive impairment or dementia, such as age, education, body mass index, diabetes, smoking, drug use, and baseline scores to brain health According to the study.

They found that 31 percent of women with normal patterns of breathing during the night developed cognitive impairment during the study period, compared with 45 percent of women who had sleep-disordered breathing. That translates to 85 percent relative odds of cognitive impairment or dementia in women with sleep-disordered breathing.

They also found that cognitive impairment is associated with episodes of lack of oxygen caused by sleep apnea, but not fragmented sleep (such as excitement or waking after sleep) or sleep duration.

Since sleep-disordered breathing affects more than 60 percent of the elderly, any association between sleep apnea and cognitive decline – even modest – could have a major impact on public health, the researchers said.

But whether or not the treatment of sleep-disordered breathing may reduce the risk of dementia or cognitive impairment is “the million dollar question,” Redline said. She said other research suggests that several months of therapy for sleep apnea may help improve brain function, but larger studies with longer treatment periods and a more diverse population to do.

“This could be a problem of the chicken and the egg,” said Dr. Gary Kennedy geriatric psychiatrist from the Montefiore Medical Center in New York. While it may be that sleep-disordered breathing contributes to cognitive impairment or dementia, the opposite may be true, dementia can contribute to sleep-disordered breathing in a way, he said.

However, Kennedy said, “This is one of the rare items, positive and hopeful. If getting oxygen anomalies are the cause of brain damage, which is a potentially reversible or preventable.”

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