Sleep Apnoea Linked To Memory Loss
People who have difficulty breathing while asleep are more likely to develop memory problems early on, a study in the journal Neurology suggests.
US scientists checked medical databases involving 2,400 people aged over 55.
Those who said they suffered from sleep apnoea reported problems with their memory and thinking skills a decade earlier than people who slept well.
Further work is under way to clarify the link. It adds to growing evidence poor sleep is associated with illness.
Signs And Symptoms Of Sleep Apnea
Family members or bed partners often pick up on the signs of sleep apnea first. Many people with sleep apnea dont know theyre snoring and gasping for breath at night. If you have any of the following signs, see your doctor:
- daytime sleepiness
- loud snoring followed by silent pauses
- gasping or choking during sleep
- morning headache
- poor concentration or memory loss
- lowered sex drive
Snoring by itself doesnt necessarily mean that you have sleep apnea. It is true that loud snoring is common in people with this disorder, but theres a big difference between simple snoring and sleep apnea.
Untreated sleep apnea can cause serious health problems. If its not treated, sleep apnea can lead to:
- high blood pressure
- work-related injuries
Sleep Apnea Changes How The Brain Works
A February 2016 study published in the Journal of Sleep Research by the UCLA School of Nursing investigated the injury caused to the insular cortex of the brain by sleep apnea. They studied levels of two important brain chemicals, called neurotransmistters: glutamate and gamma-aminobutyric acid, known as GABA. Unlike previous studies, we actually found substantial differences in these two chemicals that influence how the brain is working, said Paul Macey, the lead researcher on the study and an associate professor at the UCLA School of Nursing.
It is rare to have this size of difference in biological measures, Macey said. We expected an increase in the glutamate, because it is a chemical that causes damage in high doses and we have already seen brain damage from sleep apnea. What we were surprised to see was the drop in GABA. That made us realize that there must be a reorganization of how the brain is working.
Macey says the studys results are, in a way, encouraging. In contrast with damage, if something is working differently, we can potentially fix it.
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Here Are A Few Things You Can Evaluate About The Quality Of Your Sleep
We now have access to wonderful apps to help you monitor your sleep. This is a great place to start. The app recommended by Dr. Mark Burhenne, sleep medicine dentist, is called Sleep Analyze.
Sleep Apnea And Dementia Risk
Several researchers have studied sleep apnea to learn if, and how, it may be connected to brain functioning, memory, and risk of dementia.
In one scientific review, researchers looked at several of the prior studies that had been conducted on sleep apnea and dementia and found a strong connection between the two factors. Specifically, people who had Alzheimer’s disease were five times more likely than those without Alzheimer’s to also have sleep apnea. Additionally, they found that approximately half of the studies’ participants who had been diagnosed with dementia had experienced sleep apnea at some time after their diagnosis.
A different study published in the journal Neurology and conducted at the New York University School of Medicine outlines research conducted with more than 2000 participants. After reviewing the sleeping patterns and cognitive functioning of these participants, the researchers reached the following conclusions:
A third study found that sleep apnea was correlated with a decrease in hippocampal volume and increases in white matter lesions in the brainchanges that often occur with cognitive problems such as Alzheimer’s disease.
Researchers in a fifth study that reviewed over 400 female participants found that women with sleep apnea had a higher likelihood of cognitive problems, including dementia.
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The Capacity Of Short
Your short-term memory has a limited capacity. Certain studies conducted by the famous George Miller in the 1950s are often used as the guideline for determining how much capacity the short-term memory has. It is estimated that working memory can hold five to nine items at a time. However, newer studies have shown that in different age groups, the number is much lower, around four to five items.
The type and characteristics of the information also make a difference in how much can be stored in short-term memory. There have also been studies that have shown that short-term memory capacity and how long information remains in short-term memory can be increased if the information is said aloud.
Lowered Blood Oxygen During Sleep Can Have Consequences For Your Memory
There are three types of sleep apnea:
- Obstructive sleep apnea, in which your airway is physically blocked by improperly relaxed muscles in your throat, causing abnormal breathing during sleep
- Central sleep apnea, in which thereâs a problem with the brain signals that communicate with the muscles controlling breathing during sleep
- Mixed sleep apnea, which involves both of the above forms of the disorder
Obstructive sleep apnea is the most common form of sleep apnea, and when your sleep is interrupted, your mind struggles.
âObstructive sleep apnea can lead to serious cognitive issues related to memory loss,â Kent Smith, M.D., President of the American Sleep and Breathing Academy and Founder of Sleep Dallas, tells WebMD Connect to Care.
âDuring sleep, the brain consolidates and categorizes a dayâs events and commits them to short or long-term memory. During a sleep apnea âepisodeâ, a person actually stops breathing and the flow of oxygen to the brain is reduced or completely cut off multiple times during the night,â Smith says.
âThis, combined with chronic fatigue, can cause damage to the brainâs fiber pathways and structural alterations that regulate mood, memory, and blood pressure,â Smith explains.
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How Does Sleep Apnea Affect The Brain
Sleep apnea is an obstructive disease that affects the way you breathe while sleeping. OSA, otherwise known as obstructive sleep apnea, is the most common and the most destructive. Its no secret that sleep apnea can put a lot of stress on your heart but did you know that this condition of sleep apnea can also affect the brain?
Our sleep apnea specialist New York warns of the dangers of sleep apnea and the brain. While you may experience a range of symptoms with obstructive sleep apnea, some indicate damage to the brain.
Dont worry this damage can be reversed. Visit your sleep specialist about your best options and keep reading to learn the different ways that sleep apnea affects the brain.
More About The Research Procedure
The preliminary study was sponsored by the National Institutes of Health and lead by Dr. Diego Z. Carvalho. It included 288 patients over the age of 65 who do not currently show signs of failing memory or dementia. Data was gathered by examining the brains of the patients participating in the study using PET scans. Researchers were looking for collections of tau tangles in the temporal lobe of the brain.
Within this group, 15% of the patients had spouses or partners who had reported incidents of apnea while they were asleep. The study found that those who had a history of sleep apnea showed 4.5% higher tau levels in their entorhinal cortex than others. Researchers controlled for factors like age, sex, cardiovascular problems, and other sleep disorders.
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When To See A Doctor
According to the Mayo Clinic, you should consult a medical professional if you or your partner observes the following:
- Snoring loud enough to disturb the sleep of others or yourself
- Shortness of breath that awakens you from sleep
- Intermittent pauses in your breathing during sleep
- Excessive daytime drowsiness, which may cause you to fall asleep while you’re working, watching television or even driving
The Effect Of Osa On Visual Memory
Visual memory was distinguished from visuo-spatial memory in the current meta-analysis. Visual memory requires participants to recall visual material. Individuals with OSA showed intact visual immediate recall compared to norms and controls. At least two studies are required to conduct a meta-analysis, and this criterion was not reached for any other aspect of visual memory.
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How Does Sleep Apnea Cause Brain Damage
Sleep apnea is a breathing disorder that occurs during sleep. The airway going into the lungs become restricted or collapses completely for an extended period of time, stopping oxygen from getting into the lungs. This prohibits oxygen from getting into the lungs and being transported to the cells of the body, including the brain cells.
Oxygen is needed for proper functioning, and without it, brain cells will be damaged or die. Low levels of oxygen in the arterial blood is called hypoxemia. Hypoxemia can cause oxygen deficiency at the cellular level . Hypoxemia and hypoxia are caused by respiratory disorders, the worst sleep-related breathing disorder being OSA.
During an apnea when oxygen is not able to get into the lungs, the heartbeat gets slower and slower. As soon as the person takes a breath, the needed oxygen gets into the blood and the heart begins pumping frantically to get the life-sustaining oxygen to all the cells. A few seconds later, the airway will collapse again, causing the heart to slow its pace again. Once another breath is taken, the heart will beat frantically again, transporting the oxygen to the cells.
In very severe cases, this cycle repeats itself up to 80 or more times an hour. This feast-or-famine type of oxygen delivery system is difficult for the brain and other organs of the body to deal with, and the lack of oxygen causes cell damage to occur.
The Effect Of Osa On Visuo
Visuo-spatial memory tasks require participants to recall an image, for example, by drawing it later or recalling the specific location of the image on a grid. The control-referenced dataset provided evidence that there was significant impairment in the ability of individuals with OSA to recall visuo-spatial information immediately and following a delay. Similar to the verbal domain, the effect sizes for visuo-spatial memory were comparable for the immediate-recall and delayed-recall domains. This suggests individuals with OSA have an encoding deficit that affects recall of both visuo-spatial and verbal information.
This finding was not supported by the visuo-spatial learning result for the control-referenced dataset however, the analysis for visuo-spatial learning was based on only two studies with contrasting results, suggesting more research is required in this domain. The same OSA samples from the control-referenced dataset showed reduced or no impairment when compared to normative data.
Taken together, the visual and visuo-spatial memory analyses reveal evidence of intact immediate visual recall but impaired immediate and delayed visuo-spatial recall in OSA compared with controls. However, more evidence relating to visual memory deficits in OSA is needed before the second question can be adequately addressed.
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Why Does Sleep Apnea Cause Cognitive Decline
Mild cognitive impairment is when your memory is affected to the point that its noticeable to others, but not enough to affect your daily life. People with mild cognitive decline may show some forgetfulness or amnesia of recent events. They often need to write notes to remind themselves to do things that they would otherwise forget.
The connection between sleep apnea and cognitive decline has long been suspected. But researchers recently confirmed that those who had sleep-disordered breathing had an earlier onset of mild cognitive impairment compared with people who didnt suffer from OSA.
Whats more, other studies have shown those with sleep apnea were diagnosed with mild cognitive impairment an average of 10 years earlier than people without sleep breathing problems. And numerous other studies have made the connection between sleep apnea and dementia.
But there is hope. Researchers also found that people who treated their sleep breathing problems with a continuous positive airway pressure machine, or CPAP, were diagnosed with memory and thinking problems about 10 years later than people whose problems were not treated.
CPAP is the treatment of choice for sleep apnea, Dr. Mehra says. With this treatment, you wear a face or nasal mask while you sleep. The mask is connected to a pump and provides a flow of air into your nasal passages to keep your airways open.
Sleep Apnea Changes The Shape Of The Brain
The mental symptoms of sleep apnea are more serious than the temporary grogginess caused by drowsiness. During an apnea the subject actually stops breathing, which starves the brain of oxygen. This duress, paired with chronic fatigue, can cause physical, measurable brain damage.
Researchers at UCLA compared the mammillary bodiesstructures in the brain that are important in memory storageof several adults suffering from sleep apnea with those of healthy people. They found that the bodies in the troubled sleepers were nearly 20% smaller than in their untroubled counterparts.
Furthermore, multiple studies have discovered a decrease in both gray and white matter in the brains of subjects with OSA. A study published in Sleep journal found significant reductions in gray matter concentrations in certain areas of the brain. This led principal investigator Doctor Seung Bong Hong of the Sungkyunkwan University School of Medicine in Seoul to conclude that Poor sleep quality and progressive brain damage induced by OSA could be responsible for poor memory, emotional problems, decreased cognitive functioning and increased cardiovascular disturbances. In 2008, a UCLA study found significant damage in the brains fiber pathways and structural alterations in its white matter, especially in areas that regulate mood, memory, and blood pressure.
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What Is Sleep Apnea
Sleep apnea, which means failure to breathe during sleep, can be obstructive or non-obstructive. Non-obstructive or central apnea occurs when the brain fails to signal the breathing muscles that its time to get active. In obstructive apnea, breathing fails because of a relaxed airway that fails to open up despite the brains insistence. Eventually, sometimes after more than a minute without breathing, the brain sounds its alarms urgently enough to jolt the muscles of breathing back into action. Sometimes this wakes the sleeper, but more often the periods of apnea and gasping serve only to rob sleep of its restful and restorative quality. A respiratory infection or excessive alcohol use can also interfere with breathing during sleep. Chronic and severe apnea, however, is a prolonged, debilitating condition.
Avoid Alcohol And Sleeping Pills
If you have trouble sleeping, try a cup of decaffeinated herbal tea or juice instead of unwinding with a glass of wine. Alcohol and certain medications can make throat muscles relax more than normal. As a result, airways can get blocked. Alcohol and medications can also make it harder for your brain to “wake up” and register a lack of oxygen in the body. This can cause longer and more serious pauses in breathing. If you find it hard to fall asleep, try reading a book or taking a warm bath.
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How Does Sleep Apnea Cause High Blood Pressure
Each time a person with OSA experiences airway collapse and briefly stops breathing during sleep, their sympathetic nervous system becomes activated and blood pressure rapidly spikes when they resume breathing. Sometimes, this sequence of pausing and resuming breathing can cause a person to wake from sleep. When a person wakes up after an OSA event, activation of the sympathetic nervous system and blood pressure levels escalate to an even greater degree.
Additionally, when sleep is disrupted by OSA symptoms, the body releases sympathetic nervous system hormones called into the blood. Catecholamines are stress hormones that are majorly released by the adrenal glands. Examples of catecholamines include dopamine and epinephrine . High levels of catecholamines in the blood cause high blood pressure.
Stick To A Regular Sleep Schedule
Going to bed and waking up at roughly the same times every day helps you to get the right kind of sleep. You need to experience the full cycle of deep- and lighter-stage sleep to feel well rested. A regular sleeping schedule also prevents you from getting overtired, which can make sleep apnea symptoms worse.
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Scientists Discover Link Between Sleep Apnea And Alzheimers
The list of dangerous health problems associated with sleep apnea just keeps getting longer. As researchers work to better understand the causes, complications, and the best treatment options for OSA, they are also finding more health conditions connected to it. Now, studies have found a link between sleep apnea and Alzheimers disease.
It has been known for some time that obstructive sleep apnea has been shown to cause daytime fatigue, headaches, and cognitive impairments like memory loss, confusion, slow reaction time, and depression. It has also been connected to obesity, diabetes, hypertension, stroke, and heart disease. Recently, studies have also revealed that those with sleep apnea may also be at a higher risk of developing Alzheimers disease.
Can The Damage To The Brain Be Restored
The link between sleep apnea and changes in the state of the brain is important news for clinicians, Macey said. Especially because there is evidence that treating sleep apnea, such as with using PAP therapy, may return patients brain chemicals back to normal levels. Researchers plan to continue investigating this.
According to the American Academy of Sleep Medicine, a pair of studies evaluated the effects of CPAP therapy on several subjects who had seen significant damage to their brain matter. They found that after a year of CPAP treatment, the patients white matter was almost completely restored, while their gray matter saw substantial improvement after only three months.
This is in line with other studies that have confirmed that CPAP treatment, when used regularly, can almost completely alleviate the symptoms and effects of sleep apnea.
Are you or a loved one suffering with these brain-related symptoms of sleep apnea? If so, talk to your doctor and find out more about testing for sleep apnea. If youre ready to schedule a sleep study, click below for more information.
Editors Note: This post was originally published in November 2014 and has been edited and updated for accuracy and comprehensiveness.
Macey, P. M., Sarma, M. K., Nagarajan, R., Aysola, R., Siegel, J. M., Harper, R. M. and Thomas, M. A. , Obstructive sleep apnea is associated with low GABA and high glutamate in the insular cortex. Journal of Sleep Research. doi: 10.1111/jsr.12392
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