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Obstructive sleep apnea & cardiovascular disease links.

Obstructive sleep apnea & cardiovascular disease links.

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According to a recent study, a major contributing component in the association between obstructive sleep apnea and elevated cardiovascular risk may be decreased blood oxygen levels.

More than 4,500 middle-aged and elderly persons conducted medical check-ins and sleep tests, and the researchers analyzed the data from these participants.

According to their theories, the source of this connection may be a significant drop in blood oxygen levels during sleep. This results in severe airway blockage.

When the upper airway becomes clogged while you’re sleeping, you develop obstructive sleep apnea. The airflow of the person is reduced or stopped as a result.

One’s likelihood of getting obstructive sleep apnea is affected by a number of things, such as:

  • obesity
  • extensive tonsils
  • undergoing alterations in hormone levels.

The most prevalent form of sleep-disordered breathing is obstructive sleep apnea. According to a study from 2020, one-seventh of adults worldwide are expected to develop sleep apnea.

Previous studies have shown that obstructive sleep apnea is linked to an increased risk of cardiovascular disease.

“Sleep problems, including sleep apnea, significantly contribute to cardiovascular morbidity, as well as all-cause mortality,” Dr. Marishka Brown, head of the National Centre on Sleep Disorder Research (NCSDR), told specialists.

The relationship between obstructive sleep apnea and elevated cardiovascular risk is now the focus of a new investigation. It implies that low blood oxygen levels may be the reason of the connection.

Additional to the standard sleep apnea measurements

The Apnea Hypopnea Index (AHI) measures how many apneas or hypopneas a person has per hour of sleep. Apneas occur when breathing ceases or is diminished. The degree of obstructive sleep apnea can be determined using this traditional method.

According to Dr. Brown, “They use that for pretty much everything as far as this disorder, but what the research has been finding and really what this paper as well as strongly supporting is that there are other measures besides the use of the AHI as the primary diagnostic or prognostic for people with apnea.”

In the investigation, Dr. Brown was not involved. However, the National Heart, Lung, and Blood Institute (NHLBI), a division of the National Institutes of Health (NIH), which provided partial funding for this study, is home to the NCSDR.

In their publication describing the findings, researchers emphasize that the AHI does not offer data on the severity and duration of “ventilatory deficit, oxygen desaturation, and arousals.”

Different obstructive sleep apnea symptoms

To explain why certain persons with the disorder are more prone than others to develop cardiovascular disease or pass away, the researchers in this study detailed various physiological aspects of obstructive sleep apnea.

As Dr. Brown noted, “Recent research, especially over the past few years, has shown that patients with obstructive sleep apnea are quite heterogeneous, meaning that not all people who experience sleep apnea have the disorder for the same reason.”

To support personalized therapy, she said, “Trying to identify the mechanisms underlying obstructive sleep apnea for an individual is quite an imperative.”

The study looked at several physiological aspects of obstructive sleep apnea, including:

  • Hypoxic burden: During sleep, there is a decrease in blood oxygen levels, or hypoxic load.
  • Ventilatory burden: Breathing pauses brought on by airway blockage
  • Nighttime arousals: Arousals during the night, which occur when someone is startled awake by disrupted breathing.

“I think what they’re getting at here with these three different types of burdens from a conceptual standpoint, I can see how disruptions to sleep and in these forms might have different effects on your cardiovascular health,” said Dr. Yu-Ming Ni, a cardiologist, and lipidologist at the MemorialCare Heart and Vascular Institute at Orange Coast Medical Centre in Fountain Valley, California. He wasn’t a part of the investigation.

Effects on elderly and middle-aged people

More than 4,500 middle-aged and older adults who took part in the Multi-Ethnic Study of Atherosclerosis (MESA) and the Osteoporotic Fractures in Men Study (MrOS) provided data that the researchers analysed.

The NHLBI funded the MESA, which was created to research the features of preclinical cardiovascular disease. Researchers collected information from 1,973 men and women who took part in MESA for their investigation of the relationship between obstructive sleep apnea and cardiovascular risk. The individuals were followed for approximately 7 years, and the average participant age was 67.

2,627 men’s records from the MrOS study were used by the researchers. The subjects were followed for roughly 9 to 12 years, with an average age of 76. The MrOS project, which was supported by the NIH, sought to determine the risk factors for osteoporosis and bone fracture in older men.

Both research required participants to submit medical check-ups and thorough sleep evaluations. Participants were observed by researchers through 2018. A primary cardiovascular incident was experienced by about 110 MESA individuals and 382 MrOS participants, respectively.

REFERENCES:

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Cognitive function: Can better sleep absorption improve it?

Cognitive function: Can better sleep absorption improve it?

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The association between obstructive sleep apnea, insufficient sleep, and cognitive performance was further explored in a new research that examined data from five population-based studies.

Greater sleep consolidation and preventing obstructive sleep apnea, in which breathing is interrupted while sleeping, were connected to greater cognitive function in the subjects, according to the data.

On the other hand, less sleep was associated with concerns like poor focus and other cognitive problems.

According to a study published in JAMA Network Open, sleep consolidation and the absence of obstructive sleep apnea may be crucial for enhancing cognition with ageing in persons without dementia.

Data from five population-based studies conducted across the United States with at least five years of follow-up were examined by researchers. Studies included cognitive tests and nightly sleep studies. They examined the information from March 2020 to June 2023.

The researchers examined sleep studies that focused on sleep apnea and sleep consolidation and their relationships to dementia risk as well as associated cognitive and brain function.

5,945 persons without a history of stroke or dementia participated in the study.

The results showed that longer sleep duration was linked to better attention and processing speed, while better sleep consolidation and the absence of obstructive sleep apnea were related with worse cognitive function.

Sleep that is uninterrupted by nighttime awakenings and is continuous is referred to as consolidated sleep. The hallmark of obstructive sleep apnea is episodes of airway collapse, which can lower oxygen levels and lead to fragmented, unrestorative sleep.

What can we learn from this sleep study?

Over the course of the 5-year follow-up, the researchers discovered that stronger sleep consolidation and the lack of sleep apnea were related to better cognition.

The researchers hypothesised that these results demonstrated the necessity for additional study on the effect of therapies in enhancing consolidated sleep to preserve cognitive function.

“Some aspects [of this study] were predictable and further reinforced concepts related to the association between sleep and cognition over time,” said Dr. Vernon Williams, a sports neurologist, pain management expert, and founding director of the Centre for Sports Neurology and Pain Medicine at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles who was not involved in the research.

The lack of a correlation between cognitive deterioration and particular sleep stages was an intriguing and less expected finding in this study. A decrease in slow-wave, deep sleep would have been expected to be more harmful than other stages, however this was not the case. Though there are a lot of plausible answers, that is a fascinating discovery, said Dr. Vernon Williams.

Dr. Williams continued, “This study [further] helps by demonstrating effects across multiple participant groups and by demonstrating that overall sleep efficiency, as well as the presence of obstructive sleep apnea, significantly affect cognition over time, whether or not a prior diagnosis exists.”

Obstructive sleep apnea: What is it?

Breathing pauses during sleep are a common symptom of obstructive sleep apnea. According to the National Heart, Lung, and Blood Institute, it restarts frequently while you sleep.

According to medical professionals, between 9 and 17% of women and between 25 and 30% of males are believed to suffer from obstructive sleep apnea. Age increases prevalence.

The most prevalent kind of sleep apnea is caused by a collapse or restriction of the upper airway, which prevents airflow. When this occurs, the person briefly stops breathing before restarting it while they are sleeping, and they normally are not aware of it.

It may result in restless sleep, difficulty focusing, and issues with memory and decision-making.

The American Lung Association lists the following as symptoms of sleep apnea:

  • snoring
  • daytime slumber
  • breathing breaks
  • memory and attention issues
  • Moodiness and annoyance
  • frequent nighttime awakenings for urination
  • daily headaches
  • mouth arid.

It is connected to other medical issues as well. Obstructive sleep apnea may increase the risk of high blood pressure, diabetes, heart disease, and stroke, according to research.

How to lessen the symptoms of sleep apnea

A functional medicine physician and health and wellness coach named Dr. Laura DeCesaris, who was not involved in the study, stated that lifestyle modifications like decreasing weight, quitting smoking, and abstaining from alcohol can lessen obstructive sleep apnea.

She also provided the following advice for enhancing sleep:

  • Managing stress more skillfully and paying attention to where the body stores stress can help prevent forward head carriage and other breathing problems. Many people hold tension in their necks and shoulders.
  • monitoring your sleeping position, as side sleeping can occasionally aid with symptoms
  • Since chronic inflammation in the gut and nasal passages frequently makes it difficult to breathe through the nose, changing the diet and, when possible, switching to a more anti-inflammatory diet may be helpful.
  • exercising consistently
  • Especially in a dry area, remember to stay hydrated and consider installing a humidifier in your bedroom.

REFERENCES:

For Mental disease medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?cPath=77_478

Can Obstructive sleep apnea cause cognitive decline?

Can Obstructive sleep apnea cause cognitive decline?

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According to a study, people who have obstructive sleep apnea may experience cognitive decline.

The study is distinctive because all of its subjects were in good health and were free of the comorbid conditions that are frequently cited as the processes behind the association between sleep apnea and cognition.

According to the study, males as young as middle age can experience cognitive decline brought on by obstructive sleep apnea.

When a person has obstructive sleep apnea (OSA), their airway occasionally becomes obstructed for at least 10 seconds while they are asleep. It has been hypothesised that the cardiovascular or metabolic comorbidities that cause these breathing disruptions are the cause of the eventual decline in cognitive function.

According to a recent research of individuals without these comorbidities, sleep apnea itself can cause cognitive deterioration as early as age 40.

Men from a distinctive group took part in the study. People with systemic hypertension, hyperlipidemia, diabetes, cardiovascular disease, and other metabolic illnesses are more likely to be diagnosed with OSA.

This study is the first to examine the cognitive impact of OSA in otherwise healthy and non-obese persons because none of the study participants had any such comorbidities.

In their otherwise healthy subjects, the researchers discovered that OSA was associated with worsened executive function, visuospatial memory, vigilance (sustained attention), psychomotor function, and impulsive control.

Obstructive sleep apnea

According to a recent examination of data from 16 countries, 425 million adult men and women between the ages of 30 and 69 have moderate-to-severe OSA, and 936 million have mild-to-severe OSA. One estimate places the number of Americans with the illness at 25 million.

Sleep apnea might be one of two forms. The brain is unable to regularly signal the breathing muscles in people with less common central sleep apnea. OSA is more prevalent.

The dilator muscles that normally maintain the soft palate at the back of the throat open during breathing malfunction in people with obstructive sleep apnea or enable the tongue to impede the airway. Respiration is halted until the affected individual gasps or snorts to reopen the airway and restore breathing, which frequently happens before they completely awaken.

The link between obstructive sleep apnea and cognitive decline

According to the study’s findings, males who had severe obstructive sleep apnea had deficiencies in:

  • Vigilance
  • executive ability
  • Visual recognition memory in the short term
  • esteem on a social and emotional level

These issues were present in the males with mild obstructive sleep apnea as well, though not to the same extent as the individuals with severe versions of the illness. In reality, they hardly ever outperformed the control group in a meaningful way.

Even though the majority of men with sleep apnea had medical comorbidities, the study’s participants had none, including cardiovascular disease, diabetes, chronic inflammation, or depression. The authors pointed out that earlier studies blamed concomitant illnesses rather than sleep apnea for cognitive deficiencies.

Ivana Rosenzweig, MD, Ph.D., FRCPsych, a sleep specialist and consultant neuropsychiatrist, and the study’s lead author, said in an email to Healthline that “in our small proof-of-concept cross-sectional study, we demonstrated cognitive deficits in male patients with obstructive sleep apnea, even without any comorbidities.” This is extremely relevant because the current prevailing theory holds that cognitive deficiencies in this age range may be caused by comorbidities connected to obstructive sleep apnea.“

Rosenzweig stated, “Our research demonstrates that sleep apnea is sufficient to initiate cognitive alterations. Since the majority of these patients were (otherwise) healthy males with this condition, the vast majority of them were consciously ignorant that they already had cognitive abnormalities detected by the extremely sensitive testing battery.

The following are some potential causes of the cognitive issues, according to the researchers:

  • sporadic low oxygen
  • high blood carbon dioxide levels
  • changes in the brain’s blood flow
  • fragmented sleep
  • Neuroinflammation

They stated that sleep apnea is a disorder that could be harmful.

Sleep apnea and dementia

The chance of developing dementia, including Alzheimer’s disease, may be considerably raised by sleep apnea. An assessment of research from 2022 found that it does not appear to raise the likelihood of acquiring vascular dementia.

Unfortunately, dementia can also cause sleep disruptions, according to Merrill. “Sleep disturbances increase dementia risk,” she said. As a result, your memory may eventually deteriorate to the point of dementia, which will make it harder for you to sleep. In this way, disturbed sleep can contribute to a downward spiral, making it even more crucial to recognize and address sleep problems during early and midlife adult development. Dementia affects sleep in several different ways, Merrill continued. “Dementia is a neurodegenerative illness, which means that brain cells begin to malfunction and die as time passes.

The brain’s sleep centres begin to malfunction when a person loses brain cells, making it harder for us to communicate with our bodies to stay asleep. Sleep is frequently broken up or even inverted, keeping patients awake all night before they fall asleep for the most of the day.

Merrill stated, “Ideally, sleep will be optimised years before the potential onset of dementia.” “With better sleep, we may be able to postpone the age at which dementia first manifests itself. To increase a person’s healthy life span as much as feasible, sleep quality should be improved.

The CDC recommends that those aged 61 to 64 receive seven to nine hours of sleep per night, while those aged 65 and over should aim for seven to eight hours.

Causes of OSA and cognitive damage

“Craniofacial and physiological particularities can be a risk factor for OSA — having a short chin, large tonsils, a large tongue, etc.,” said neuroscientist Dr. Nadia Gosselin from the University of Montreal in Canada, who was not involved in the study.

According to her, “these peculiarities increase a person’s risk of upper-airway obstruction during sleep.”

Although it is unclear how OSA causes cognitive loss, several of its fundamental characteristics, such as sleep disruption, intermittent hypoxemia, neuroinflammation, and oxidative stress, may be to blame.

According to Dr. Gosselin, OSA stops sleep from playing its part in memory consolidation, brain plasticity, and the elimination of cerebral metabolic waste by continuously fragmenting sleep.

She stated that systemic inflammation and blood-brain barrier disruption resulting in neuronal death are two more potential causes.

According to one study, the hippocampus and the entorhinal cortex, two areas of the brain that degrade quickly in Alzheimer’s disease, have higher levels of oxidative stress and inflammation.

How to treat sleep apnea

The good news is that OSA can frequently be treated by making small lifestyle adjustments, such eating better, working out more, and decreasing weight, she continued.

Through a range of therapy techniques, doctors can also assist patients in controlling OSA.

The CPAP machine, which uses continuous positive airway pressure to keep the airway open while you sleep, is the OSA technology that is used the most frequently. People with central sleep apnea may also be given medication, CPAP machines, or other breathing aids.

Other OSA therapies include oral mandibular advancement devices or dental appliances that prevent the tongue from obstructing the throat. Additionally, there are neurostimulation implants for OSA, and surgery can occasionally be beneficial.

REFERENCES:

For Cognitive decline medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?cPath=77_478