Obstructive sleep apnea may be linked to microbleeds in the brain

A woman demonstrates how she puts on her sleep apnea breathing device at her home in Los Angeles Thursday, July 12, 2018. (AP Photo/Reed Saxon)

Maybe you know you snore like a bear, but you don’t feel much urgency to look into it. Or maybe you have been told to wear a continuous positive airway pressure, or CPAP, machine for sleep apnea, but it is just so cumbersome.

A new study shows that it is important to take obstructive sleep apnea seriously now –– it could impact your risk of dementia and Alzheimer’s disease later.

Moderate to severe obstructive sleep apnea is associated with a greater risk for new microbleeds in the brain, according to the study.

“Cerebral microbleeds are a common finding in the aging brain,” said Dr. Jonathan Graff-Radford, professor of neurology at Mayo Clinic College of Medicine in Rochester, Minnesota. He was not involved in the research.

Microbleeds increase with age, and people who have them have a slightly higher risk of future strokes and faster cognitive decline, Graff-Radford said. “Anything that increases microbleeds is relevant to brain aging,” he added.

More evidence you need to treat sleep apnea

Obstructive sleep apnea is a condition in which a blockage of airways by weak, heavy or relaxed soft tissues disrupts breathing during sleep. The condition is different from central sleep apnea, in which the brain occasionally skips telling the body to breathe.

There are a few ways to treat obstructive sleep apnea, including relying on oral devices that keep the throat open during sleep, regularly using a CPAP or similar machine, and having surgeries.

The study has a strong methodology and should stress the importance of screening for sleep apnea to clinicians and treatment to patients, said Dr. Rudy Tanzi, professor of neurology at Harvard Medical School and director of the Genetics and Aging Research Unit at Massachusetts General Hospital in Boston. He was not involved in the research.

“Don’t ignore it. Do something about it,” he said. “It’s not just the immediate risk for down the road for bleeds, but also later down the road for Alzheimer’s disease as well.”

Not addressing obstructive sleep apnea is a double whammy, Tanzi said. Not getting enough good-quality sleep –– which can be hard to do when your breathing is impaired during the night –– has been associated with brain aging, but the microbleeds that could result may increase the risk for dementia down the line.

The study, which was published in the journal JAMA Network Open Tuesday, is observational, which means that it can only establish that obstructive sleep apnea and microbleeds are associated, not that one definitively causes the other. Further studies will need to examine if treating sleep apnea can prevent microbleeds.

Know the signs

When is it time to ask your doctor about obstructive sleep apnea?

Loud, frequent snoring is a good indicator, Tanzi said. If your partner notices pauses in your breathing while you sleep or gasping and choking, that’s another sign you should look into sleep apnea.

Problems during the day can be a good indicator, too. Sleepiness, trouble concentrating, irritability and increased hunger are signs you may not be getting quality sleep and that it may be time to get assessed for sleep apnea.

Night sweats might also be a sign of sleep apnea, as research has shown that about 30 per cent of people with obstructive sleep apnea have reported night sweats.

Waking up at least two times in the night, teeth grinding, and morning headaches might also indicate a problem.

The latest study “urges (people) to take it more seriously, because the damage that can come from obstructive sleep apnea can definitely be more severe than you think,” Tanzi said.

By Madeline Holcombe, CNN