Thursday, September 22, 2011

Sleep Apnea and Dementia

SLEEP APNEA  . . . AND DEMENTIA?

Sleep apnea is a condition wherein one stops breathing while asleep.  It consists of three different types:  Obstructive, central and mixed. Obstructive sleep apnea is a condition in which pauses in breathing occur during sleep because the airway has become narrowed, blocked, or floppy   In central sleep apnea, breathing is disrupted regularly during sleep because of the way the brain functions.  Mixed is seen in persons who have both obstructive and central sleep apnea.

For some time, it has been known to cause serious health problems.  For example, it can increase the risk for stroke, obesity, diabetes, heart attack, heart failure, irregular heartbeat, and high blood pressure. It may also increase the risk for accidents while working or driving, as some people with sleep apnea may fall asleep during those activities.*

Sleep apnea is now associated with dementia:

A recent study has uncovered an association between women who suffer from sleep apnea and the likelihood of developing dementia. Oxygen intake levels could be the culprit as a lack of the element may stunt long term memory. [emphasis added] Among the women found to suffer from sleep disordered breathing, 44.8% of them developed dementia or mild cognitive impairment, compared with 31.1% of those who didn't have impaired breathing and sleep.#

Female sleep apnea sufferers experience a 13.1% increase in dementia cases.  It is thought that oxygen deprivation is the main culprit.  

These findings are different from those cited in a 2005 report.  It indicates that significant cognitive impairment occurs with sleep deprivation.  This study was done with interns in a hospital--some of the most sleep-deprived people.  Jerry M. Ellenbogen, MD cited the following study when he discussed the adverse effects of sleep deprivation.   

Sleep loss causes profound impairments in cognitive and behavioral performance. For example, in a prospective, randomized study looking at the effects of sleep deprivation in residency training, interns working a “traditional schedule” made 36% more serious medical errors compared with interns under an “intervention schedule” that included more sleep.^

Ellenbogon says that the detriments resulting from sleep loss include impaired cognitive and behavioral performance.  These losses result partly from, “diminished attention and arousal.  The loss of benefits due to the lack of sleep includes missing sleep dependent cognitive processing such as memory consolidation and insight formation.”-

Perhaps these findings explain why there are so many who suffer from memory problems.  These studies point out just a few of the complexities associated with sleep disorders, especially those caused by sleep apnea.  For patients who are non-compliant c-pap users, these findings provide additional reasons to use this life-saving equipment. There are many undiagnosed  sleep apnea sufferers.  Therefore, anyone who feels tired and unrested should discuss these symptoms with their doctor.   

*http://www.webmd.com/sleep-disorders/central-sleep-apnea
^Landrigan CP, Rothschild JM, Cronin JW, et al. Effects of reducing interns’ work hours on serious medical errors in intensive care units.  N Engl J Med 2004;351:1838–1848.

These articles do not include medical advice.  Please see your physician with any questions.