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A study indicates that people with sleep apnea develop brain damage. How can it be treated?

2023-04-06T12:51:30.688Z


The research revealed that middle-aged men diagnosed with this pathology showed worse mental function in areas such as judgment, impulse control and recognizing other people's feelings.


By Linda Carroll -

NBC News

Most people with untreated sleep apnea develop heart disease, and researchers have surmised that as a result they also have cognitive problems.

But a recent small study reveals that obstructive sleep apnea itself damages the brain, making it all the more urgent to recognize and treat the disorder.

According to a study published Thursday in Frontiers in Sleep, middle-aged men diagnosed with obstructive sleep apnea had worse mental function in areas such as judgment, impulse control and recognizing other people's feelings, compared with men who did not have the disease.

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Obstructive sleep apnea, the most common form, occurs when the muscles in the throat relax and the airways become obstructed.

Another type is central sleep apnea, which occurs when the brain doesn't send the right signals to the muscles that control breathing.

In both cases, people wake up briefly due to the need for oxygen.

For the new study, the researchers recruited 27 men between the ages of 35 and 70 who were not overweight and who had recently been diagnosed with mild to severe obstructive sleep apnea.

Seven men of similar age, body weight, and educational level who did not have sleep apnea were also included.

Both groups underwent a series of tests.

Men with obstructive sleep apnea showed cognitive deficits that increased with severity.

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According to the American Academy of Sleep Medicine, it is estimated that up to 26% of American adults between the ages of 30 and 70 have sleep apnea.

According to experts, this may be an underestimate, as this condition is so underdiagnosed.

It is believed to affect men more than women.

Sleep apnea has been linked to memory and thinking problems, but the new study reveals that cognition is affected even when men have no underlying health problems, underscoring the importance of treating it early, he says in an email. Dr. Ivana Rosenzweig, a neuropsychiatrist and co-lead author of the study, who directs the Center for Sleep and Brain Plasticity at Kings College London.

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"Our patients were mostly unaware of their cognitive deficits," Rosenzweig said, adding that the participants would not have sought help "if it weren't for snoring and bothering their partners."

The new study is small, and Rosenzweig would like the researchers to do larger studies that include women. 

Until menopause, women are much less likely to develop this sleep disorder;

however, its prevalence in women increases dramatically with age and weight, according to Rosenzweig. 

"After menopause it almost equals between both sexes," he says.

What causes sleep apnea?

It's not clear why obstructive sleep apnea causes cognitive deficits, although scientists suspect that the frequent, albeit brief, awakenings cause fragmented sleep, and that periods when breathing stops briefly cause temporary drops in oxygen levels. in blood.

Risk factors for obstructive sleep apnea are:

  • Overweight.

  • Arterial hypertension.

  • Chronic nasal congestion.

  • Narrowing of the airways.

  • Diabetes.

  • Asthma.

People often don't know they have sleep apnea, Rosenzweig says.

They tend to seek help only when their partners tell them there is a problem, such as snoring.

“There may be signs, such as morning headaches or increased daytime sleepiness and fatigue,” he explains.

Sleep apnea may be worse for your health than insomnia because it can make it harder for the brain to achieve deep sleep, said Dr. Joel Salinas, a behavioral neurologist and researcher at NYU Langone Health and medical director of Isaac Health in New York.

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During sleep, the brain goes through different phases, such as light sleep, deep sleep, and rapid eye movement (REM) sleep, which is when you dream.

Deep sleep, also known as stage 3 sleep, is when memories are stored and the brain cleans up proteins that could cause damage over time, said Salinas, who was not involved in the new study.

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“People with obstructive sleep apnea don't spend a lot of time in phase 3, but instead wake up in phase 2 and then go back to phase 1,” he explains.

“Over time, these people appear to have increased buildup of proteins, such as amyloid, which can increase their risk of cognitive decline or dementia,” Salinas said.

Sleep Apnea Treatments

Doctors use numerous strategies to treat sleep apnea, according to Dr. Andrew Varga, a neuroscientist and physician at the Mount Sinai Integrative Sleep Center and associate professor of medicine at the Icahn School of Medicine at Mount Sinai in New York.

Varga was not involved in the new study.

The most common is the continuous positive airway pressure, or CPAP, machine, which keeps the airways open during sleep.

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There are also mandibular advancement devices that hold the lower jaw forward to keep the airway open.

“They are the second most popular method,” says Varga.

There are also operations to modify throat structures.

They can be as minimally invasive as removing the uvula, the fleshy structures that hang over the throat, and part of the soft palate, the muscular part of the palate, Varga explains.

Some patients rely on implantable pacemaker-like devices that signal the nerves to the tongue to push it forward.

At the more invasive end of the spectrum is surgery to reconstruct the jaw.

“The jaw is broken on both sides and then pushed forward,” Varga explains.

Brain studies have shown decreased activity in areas similar to those seen in people with neurodegenerative diseases, Salinas explains.

That's why it's important to treat this type of sleep apnea early, she added.

Lifestyle changes are a good starting point, he said.

“It is always important to address all potentially reversible problems, such as being overweight and high blood pressure,” he said.

"The sooner these issues are addressed and controlled long-term, the greater the impact and the likelihood of having a healthy brain for the rest of your life."

Source: telemundo

All news articles on 2023-04-06

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