Sleep Apnea May Be Damaging Your Brain

Sleep apnea is a serious sleeping disorder that, if left untreated, can significantly increase your risk for heart attack, stroke, high blood pressure and irregular heart rhythms such as atrial fibrillation. And research is increasingly pointing to the disorder’s impact on your brain and cognitive abilities.

This could affect you in a number of ways, making it more difficult for you to concentrate, remember things and make decisions. It could also affect the way you react to other people and situations and make you more anxious and depressed.

What Is Sleep Apnea?

Sleep apnea is a condition in which your breathing periodically stops while you are sleeping. This can cause your oxygen levels to drop significantly, while disrupting your sleep patterns. There are two versions of the disorder:

• Obstructive sleep apnea: This is caused when the relaxed muscles in the back of your throat collapse and block your airway while you sleep. You may stop breathing for several seconds, or in some cases over a minute at time. Depending on the severity, this can occur as many as 100 times an hour or more. Major contributors to the development of sleep apnea include obesity, family history and facial structure.
• Central sleep apnea: This less common form of the disorder occurs when your brain isn’t telling your lungs to breathe, creating pauses in your breathing patterns.

You may not even realize you have sleep apnea unless your partner notices your breathing issues – including loud gasps as your breathing stops and restarts.

One of the key neurological symptoms is having difficulty regaining focus when you wake up in the morning. Everyone has that to some degree. But with sleep apnea it may be more pronounced, while slowing improving as the day goes on. This can include forgetfulness, decreased concentration, mood swings and decrease in productivity.

Other symptoms include:

• Snoring
• Difficulty staying awake during the day, even while working or driving
• Difficulty concentrating
• Trouble falling back to sleep after waking up at night
• Limb Movements or restless leg syndrome
• Feeling tired when you wake up in the morning

How Sleep Apnea Affects the Brain

When you aren’t breathing, your brain isn’t getting the oxygenated blood it needs to thrive. The sensitive neurons in your brain need that blood to stay healthy and avoid early neurocognitive decline. This lack of adequate blood flow can also change the structure of your brain, which is forced to adapt to its new environment.

There is a long, documented history of sleep apnea patients suffering cognitive problems earlier in life than would typically be expected. Studies have shown that obstructive sleep apnea is linked to declining mental abilities, including memory and attention. More recently, a study published in JAMA Neurology in 2023 found that people with sleep apnea are more likely to develop cognitive issues as they get older. People with the disorder are also more likely to experience conditions like Parkinson’s disease, seizures and issues with visual memory and processing.

Treating Sleep Apnea

For mild cases of sleep apnea, your doctor may start with lifestyle modifications, including losing weight and improving sleep hygiene such as avoiding sedatives or alcohol before bed. Sometimes, Changing your sleep position or wearing a special dental device at night may help.

Oral appliances can help keep your throat open while you sleep by gently pushing your jaw forward, effectively opening your throat.

The gold standard for treating sleep apnea is continuous positive airway pressure, more commonly known as CPAP therapy. The option works for 80 percent of patients with sleep apnea.

The therapy uses a machine that provides positive pressure to keep the upper airway open while you sleep. It requires you to wear a mask that fits over your nose or nose and mouth. As you sleep, the machine sends a steady flow of air through a hose connected to your mask, keeping your airway open and preventing obstruction.

For some people, the CPAP may not provide enough control of sleep apnea. Among other airway devices is a BPAP (bilevel positive airway pressure), which applies more air pressure when you inhale and less when you exhale.

There are, however, some people who cannot tolerate sleeping with a mask. It can restrict sleeping positions or cause feelings of claustrophobia.

Surgery may be an option. Previous surgical options included removing portions of the tissues in the back of the throat or repositioning the jaw.

Recent advances in nerve stimulation technology use a pacemaker-like device that is implanted in your right chest wall and stimulation along the hypoglossal nerve. The implant monitors your respiratory cycle and, when needed, stimulates the hypoglossal nerve which causes stiffening of the throat muscles to keep the airway open and prevent obstruction from the inside out.

Your doctor will help you find the treatment that is right for you.