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Obstructive sleep apnea is a common condition that impacts about 39 million adults in the U.S. But if it’s left untreated, it raises the risk of developing a host of serious conditions, including heart, kidney, and metabolic health complications.
Now, new research finds there’s another potential health issue to add to the list: Dementia. And unfortunately, the link is even stronger for women.
But what’s behind this association and what can you do to lower your risk? Here’s the deal.
Meet the experts: W. Christopher Winter, MD, a neurologist and sleep medicine physician with Charlottesville Neurology and Sleep Medicine and host of the Sleep Unplugged podcast. David Merrill, MD, PhD, a geriatric psychiatrist at Providence Saint John’s Health Center in Santa Monica, CA, and Singleton Endowed Chair in Integrative Brain Health.
What did the study find?
The study, which was published in the journal SLEEP Advances in October, analyzed survey and cognitive screening data from more than 18,500 adults.
The researchers discovered that people aged 50 and up with obstructive sleep apnea had a higher chance—up to five percent higher—of being diagnosed with dementia in the future. The link was still statistically significant after researchers accounted for factors that can impact dementia risk, like race and education.
In every age group, women who had a known or suspected sleep apnea diagnosis were more likely than men to be diagnosed with dementia. “This study illuminates the impact of a potentially modifiable yet frequently overlooked risk factor for dementia onset,” the researchers concluded.
Why was sleep apnea linked with a higher risk of dementia?
The study didn’t find why there was a link—it merely found that there was one. However, there are some theories.
“Sleep apnea is highly disruptive to sleep architecture,” says W. Christopher Winter, MD, a neurologist and sleep medicine physician with Charlottesville Neurology and Sleep Medicine and host of the Sleep Unplugged podcast. “We know that the glymphatic system in our brain (that pumps out waste products) is much more active and efficient during healthy sleep. Sleep apnea is very pro-inflammatory and elevates blood pressure and vascular risk, which is a huge risk factor in dementia.”
Poor sleep also causes acute and chronically worsening changes in the brain, says David Merrill, MD, PhD, a geriatric psychiatrist at Providence Saint John’s Health Center in Santa Monica, CA, and Singleton Endowed Chair in Integrative Brain Health.
“Normally, a good night’s sleep literally allows for repair and restoration of brain function to the levels seen at the beginning of the prior day,” he says. But when someone has sleep apnea, that repairing ability doesn’t work as well, Merrill says.
Why is this association more pronounced in women?
It’s not clear yet—more research is needed.
“It could be hormonal or represent women being more sensitive to the cardiovascular effects of sleep apnea,” Winter says. “I suspect it might relate more to differing diagnostic rates of sleep apnea in men and women.”
If my sleep apnea is treated, does it still increase the risk of dementia?
Sleep apnea treatments include things like trying to maintain a healthy weight, sleeping on your side, and using a breathing machine like a continuous positive airway pressure (CPAP) machine, per the National Heart, Lung, and Blood Institute (NHLBI).
“Treating the sleep apnea absolutely lowers dementia risk in the future,” Winter says. “It’s probably like smoking and lung cancer. While the baseline risk may still be higher than the non-sleep apnea population, it is nevertheless going to be greatly reduced over where that woman would have been if she ignored her snoring and breathing disturbances at night.”
He also points out that having your sleep apnea treated will help you to feel better and more energetic. “It’s the brain gift that keeps on giving,” he says.
How can I reduce my risk of dementia?
The exact cause of dementia hasn’t been pinpointed, but doctors generally believe that it’s due to a variety of factors. To lower your risk of developing dementia, the Centers for Disease Control and Prevention (CDC) recommends doing the following:
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Stay physically active
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Try to prevent or manage diabetes
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Manage your blood pressure
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Try to prevent or correct hearing loss
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Try to limit or avoid drinking alcohol and smoking
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