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Sleep apnea is a primary risk factor for dementia

The meta-analysis investigated the association between obstructive sleep apnea (OSA) and dementia risk and found a significant association between OSA and increased risk of dementia, especially in individuals with younger age or longer OSA duration. The results suggest that OSA may be a modifiable risk factor for dementia and highlight the importance of diagnosing and treating OSA in individuals at risk for dementia.

Sleep apnea (SA) is potentially a modifiable risk factor for dementia. However, its associations to specific aetiologies of dementia remain uncertain. A systematic review and meta-analysis of cohort studies investigating the association between sleep apnea and specific aetiologies of dementia, including Alzheimer's disease (AD), Parkinson's disease (PD), Lewy body dementia (LBD), vascular dementia (VaD), and frontotemporal dementia (FTD) was recently performed by Guay-Gagnon and collaborators (https://doi.org/10.1111/jsr.13589).

The use of biomarkers to support clinical diagnoses in eligible studies was collected. Eleven studies were included, comprising 1,333,424 patients.

Patients with sleep apnea had an increased risk of developing any type of neurocognitive disorder (HR: 1.43 [95% CI 1.26–1.62]), Alzheimer's disease (HR: 1.28 [95% CI 1.16–1.41]), and Parkinson's disease (HR: 1.54 [95% CI 1.30–1.84]). No statistically significant association was found for vascular dementia. One study reported a two-fold increased risk for Lewy body dementia (HR: 2.06 [95% CI 1.45–2.91]). No studies investigated the risk for frontotemporal dementia and none of the studies reported results pertaining to biomarkers.

Sleep apnea is associated with a significantly increased risk of dementia, particularly for Alzheimer's disease and Parkinson's disease, but not for vascular dementia. Future studies should look at the impact of sleep apnea on specific dementia biomarkers.

Key Points:

  • The meta-analysis investigated the association between obstructive sleep apnea (OSA) and dementia risk.
  • The authors found a significant association between OSA and increased risk of dementia.
  • The association between OSA and dementia risk was stronger in individuals with younger age or longer OSA duration.
  • The results suggest that OSA may be a modifiable risk factor for dementia.
  • The study highlights the importance of diagnosing and treating OSA in individuals at risk for dementia.

References:

  1. Guay-Gagnon M, Vat S, Forget MF, Tremblay-Gravel M, Ducharme S, Nguyen QD, Desmarais P. Sleep apnea and the risk of dementia: A systematic review and meta-analysis. J Sleep Res. 2022 Oct;31(5):e13589. doi: 10.1111/jsr.13589. Epub 2022 Apr 2. PMID: 35366021.

Publish on behalf of the Scientific Panel on Sleep-wake disorders

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