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A recent study suggests that sleep apnea may increase the likelihood of developing dementia, with the effect being particularly strong in women. The study, conducted by a team from the University of Michigan and led by Dr Tiffany Braley, shows the importance of early diagnosis and treatment for sleep apnea as a preventive measure against potential cognitive decline.

Published in the journal Sleep Advances, the study followed the health outcomes of over 18,500 adults aged 50 and older. These participants completed comprehensive questionnaires on their sleep quality and underwent cognitive assessments to evaluate their brain health. The findings revealed that those with a history of sleep apnea, or even symptoms indicating potential sleep apnea, had up to a 5 per cent higher risk of developing dementia. Although 5 per cent might seem modest, this figure remained consistent even after the researchers accounted for variables such as race and educational background, which are also known to influence dementia risk.

Interestingly, the link between sleep apnea and dementia risk was more pronounced in women than in men, though the reasons behind this gender disparity are still unclear. Researchers suggest that hormonal factors, specifically those related to menopause, could be at play. As women enter menopause, they experience a decline in estrogen, which has been linked to changes in memory, sleep patterns, and mood. Dr Galit Levi Dunietz, a co-author of the study and associate professor in neurology and sleep medicine, emphasized the need for more research to explore how sleep disorders impact cognitive health in women.

"Estrogen starts to decline as women transition to menopause, which can impact their brains,” Dunietz explained. “During that time, they are more prone to memory, sleep, and mood changes that may lead to cognitive decline. Sleep apnea rates increase significantly post-menopause yet remain underdiagnosed."

In addition to hormonal changes, untreated sleep apnea has been associated with heart disease and insomnia, two conditions that can negatively impact brain health. For both men and women, sleep apnea disrupts sleep and causes sleep fragmentation, which leads to inflammatory changes in the brain that may worsen cognitive impairment over time.

While the study demonstrates a link between sleep apnea and dementia, it does not establish a direct cause-and-effect relationship. According to Dr Ronald Chervin, director of the Division of Sleep Medicine at the University of Michigan Health, proving causality would require a long-term randomized trial comparing outcomes for patients who receive treatment for sleep apnea with those who do not.

However, the researchers hope that their findings will encourage healthcare providers and patients to take sleep apnea more seriously as a risk factor for cognitive decline. "Clinicians and patients, when making decisions about testing for sleep apnea and treating it, should consider the possibility that untreated sleep apnea causes or exacerbates dementia," Chervin advised.

Lifestyle changes, medical devices, and other treatments are available for those looking to manage sleep apnea and potentially reduce cognitive risks.

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