Is Sleep Apnea Connected to Dementia?
Hi,
I've noticed that my aunt is snoring a lot and sleeping more and more during the day. She used to sleep at night and be awake during the day. She is also snoring so loudly that it keeps my uncle awake all night. Last week, she had a urinary tract infection and we had to take her to the hospital. I told the doctor that I suspected she might have sleep apnea. Fortunately, he was willing to listen and he said , ok while she's here we will run a sleep study.
They tested her overnight and sure enough, she has severe sleep apnea. They fitted her with a machine, I think it is called a CPAP machine. It has made an observable difference in her life. Maybe this will help someone else.
Rachel
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Is sleep apnea common in people with dementia? Does it rank high on the list things for which I oughta watch?
YES! Charlie, most people with dementia get sleep apnea at some station along the journey.
According to Dr. Sonia Ancoli-Israel, professor of psychiatry at UCSD, almost half of older adults experience apnea to some degree, with even higher rates among those with dementia.
“It’s under-recognized in all age groups,” she says. “But in older people, physicians are even less likely to recognize it.”
Why? She says that loud snoring may go unnoticed when seniors live alone. And there’s that belief that old people are supposed to be sleepy during the day.
They’re not. Recognize the problem. There is a now-established connection between apnea and the cognitive decline we often mistakenly blame on the dementia. Dr. Ancoli-Israel said, “If you’re waking up hundreds of times a night and you’re not getting enough oxygen to the brain, of course you’ll see the effect.”
At the same time, the cognitive problems won’t evaporate right away when someone is treated for sleep apnea. But research shows that the CPAP machines mentioned above by Rachel and Nurse Dina achieve noticeable improvements.
Dr. Bradley Boeve, a neurologist at the Mayo Clinic, says “They’re not dozing off during the day, they’re not dragging. Quality of life improves.”
Life gets easier for their caregivers, too, a key concern in trying to keep people out of nursing homes.
But when someone with apnea does stick with the treatment, “you’ll see the effects within a month or so,” Dr. Boeve said. “Sometimes even within a week.”
Hi Rachel,
Thank you for sharing your experience with your aunt. I do think that our readers will find this information helpful. Before I discuss the connection between sleep apnea and dementia, I'd like to briefly explain what sleep apnea is.
What is sleep apnea?
Sleep apnea is a sleep disorder characterized by abnormal pauses in breathing or instances of abnormally low breathing, during sleep. Each pause in breathing, can last from a few seconds to minutes, and may occur many times each hour.
What causes sleep apnea?
When one is awake, throat muscles help keep the airway stiff and open so air can flow into your lungs. When asleep, these muscles are more relaxed. With sleep apnea, the airway can be blocked or narrowed during sleep because:
What are the symptoms of sleep apnea?
The main symptoms are usually associated with excessive daytime sleepiness:
Other symptoms may include:
How is it diagnosed?
Sleep apnea is diagnosed with an overnight sleep test called a "sleep study", it is often done in a sleep lab. If you need help finding a sleep practitioner or a sleep care center, you can contact the National Sleep Foundation.
How is it treated?
The goal of treatment is to help to keep the airway open so that breathing does not stop during sleep.
Making lifestyle changes such as loosing weight, or avoiding sleeping on one's back, may at times, relieve the symptoms of sleep apnea. CPAP (continuous positive airway pressure) is the first-line treatment for obstructive sleep apnea in most people. CPAP is a treatment that delivers slightly pressurized air during the breathing cycle. This keeps the windpipe open during sleep and prevents the episodes of blocked breathing.
What are the health risks if sleep apnea is not treated?
Untreated sleep apnea can lead to or worsen cardiovascular disease. It would also stand to reason that sleep apnea would be a contributing factor to dementia because it can cause lower the levels of oxygen in the brain. Over time, this may contribute to brain cells dying.
Can folks with sleep apnea act like they have dementia?
In a study published in the Journal of the American Geriatrics Society called: "Cognitive Effects of Treating Obstructive Sleep Apnea in Alzheimer's Disease: A Randomized Controlled Study", researchers examined whether treatment of sleep apnea with CPAP in patient's with Alzheimer's made a difference. They concluded that sleep apnea may aggravate cognitive dysfunction in dementia and may be a reversible cause of cognitive loss in patients with Alzheimer's. Treatment seems to improve some cognitive functioning.
In other words, if someone already has dementia, and is treated for sleep apnea, the dementia will not go away; however, with the use of CPAP, things do improve. The rates of sleep apnea are higher among the elderly and the condition is often undetected. If you suspect that you or someone you love has sleep apnea, go get tested. It may help improve your quality of life,
Dina