The Importance of Diagnosing and the Clinical Potential of Treating Obstructive Sleep Apnea to Delay Mild Cognitive Impairment and Alzheimer’s Disease: A Special Focus on Cognitive Performance

Obstructive sleep apnea (OSA) is a highly frequent sleep disorder in the middle-aged and older population, and it has been associated with an increased risk of developing cognitive decline and dementia, including mild cognitive impairment (MCI) and Alzheimer’s disease (AD). In more recent years, a growing number of studies have focused on: 1) the presence of OSA in patients with MCI or AD, 2) the link between OSA and markers of AD pathology, and 3) the role of OSA in accelerating cognitive deterioration in patients with MCI or AD. Moreover, some studies have also assessed the effects of continuous positive airway pressure (CPAP) treatment on the cognitive trajectory in MCI and AD patients with comorbid OSA. This narrative review summarizes the findings of studies that analyzed OSA as a risk factor for developing MCI and/or AD in the middle-aged and older populations with a special focus on cognition. In addition, it describes the results regarding the effects of CPAP treatment in hampering the progressive cognitive decline in AD and delaying the conversion to AD in MCI patients. Considering the importance of identifying and treating OSA in patients with MCI or AD in order to prevent or reduce the progression of cognitive decline, further larger and adequately powered studies are needed both to support these findings and to set programs for the early recognition of OSA in patients with cognitive impairment.

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IC-P-002: OBSTRUCTIVE SLEEP APNEA, BRAIN BETA-AMYLOID MEASURES AND TIME-TO-PROGRESSION FROM MILD COGNITIVE IMPAIRMENT TO ALZHEIMER'S DISEASE

Alzheimer s & Dementia ◽

10.1016/j.jalz.2018.06.2066 ◽

2006 ◽

Vol 14 (7S_Part_1) ◽

pp. P15-P15

Author(s):

Omonigho Michael Bubu ◽

Maddie Birckbichler ◽

Fahad Mukhtar ◽

Megan Hogan ◽

Amanda Shim ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Obstructive Sleep Apnea ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Sleep Apnea ◽

Beta Amyloid ◽

Time To Progression ◽

Obstructive Sleep

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Obstructive sleep apnea and Alzheimer’s disease-related cerebrospinal fluid biomarkers in mild cognitive impairment

SLEEP ◽

10.1093/sleep/zsaa133 ◽

2020 ◽

Author(s):

Mónica Díaz-Román ◽

Matias M Pulopulos ◽

Miguel Baquero ◽

Alicia Salvador ◽

Ana Cuevas ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Obstructive Sleep Apnea ◽

Cerebrospinal Fluid ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Sleep Apnea ◽

Apnea Hypopnea Index ◽

Obstructive Sleep ◽

T Tau

Abstract Previous studies have demonstrated that sleep-breathing disorders, and especially obstructive sleep apnea (OSA), can be observed in patients with a higher risk of progression to Alzheimer’s disease (AD). Recent evidence indicates that cerebrospinal fluid (CSF) AD-biomarkers are associated with OSA. In this study, we investigated these associations in a sample of patients with mild cognitive impairment (MCI), a condition that is considered the first clinical phase of AD, when patients showed biomarkers consistent with AD pathology. A total of 57 patients (mean age = 66.19; SD = 7.13) with MCI were included in the study. An overnight polysomnography recording was used to assess objective sleep parameters (i.e. apnea/hypopnea index [AHI], total sleep time, sleep efficiency, sleep latency, arousal index, awakening, stage 1, 2, and slow-wave sleep and rapid eye movement sleep, periodic limb movement index, O2 saturation during sleep, and percentage of time O2 saturation <90%). Phosphorylated-tau (P-tau), total-tau (T-tau), and amyloid-beta 42 (Aβ42) were measured in CSF. Unadjusted correlation analyses showed that a higher AHI (reflecting higher OSA severity) was related to higher P-tau and T-tau (both results remained significant after Bonferroni correction, p = 0.001). Importantly, these associations were observed even after adjusting for potential confounders (i.e. age, sex, body mass index, sleep medication, smoking, hypertension, and heart disease). Although more research is needed to establish a causal link, our findings provide evidence that OSA could be related to the pathophysiological mechanisms involved in neurodegeneration in MCI patients.

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O1-11-01: OBSTRUCTIVE SLEEP APNEA, BRAIN BETA-AMYLOID MEASURES AND TIME-TO-PROGRESSION FROM MILD COGNITIVE IMPAIRMENT TO ALZHEIMER'S DISEASE

Alzheimer s & Dementia ◽

10.1016/j.jalz.2018.06.2390 ◽

2006 ◽

Vol 14 (7S_Part_4) ◽

pp. P246-P247

Author(s):

Omonigho Michael Bubu ◽

Maddie Birckbichler ◽

Fahad Mukhtar ◽

Megan Hogan ◽

Amanda Shim ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Obstructive Sleep Apnea ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Sleep Apnea ◽

Beta Amyloid ◽

Time To Progression ◽

Obstructive Sleep

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IC-P-118: βETA-AMYLOID BURDEN MODIFIES CONVERSION RISK IN CLINICALLY NORMAL AND MILD COGNITIVE IMPAIRMENT OBSTRUCTIVE SLEEP APNEA ELDERLY INDIVIDUALS

Alzheimer s & Dementia ◽

10.1016/j.jalz.2019.06.4232 ◽

2019 ◽

Vol 15 ◽

pp. P100-P100

Author(s):

Omonigho M. Bubu ◽

Ogie Queen Umasabor-Bubu ◽

Andreia G. Andrade ◽

Maddie Birckbichler ◽

Ram A. Sharma ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Sleep Apnea ◽

Amyloid Burden ◽

Elderly Individuals ◽

Clinically Normal ◽

Obstructive Sleep

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[IC-P-009]: OBSTRUCTIVE SLEEP APNEA IS ASSOCIATED WITH LONGITUDINAL INCREASES IN AMYLOID BURDEN IN ELDERLY MILD COGNITIVE IMPAIRMENT INDIVIDUALS

Alzheimer s & Dementia ◽

10.1016/j.jalz.2017.06.2281 ◽

2017 ◽

Vol 13 (7S_Part_1) ◽

pp. P15-P16 ◽

Cited By ~ 1

Author(s):

Megan Hogan ◽

Amanda Shim ◽

Kathryn Halldin ◽

Hannah Clark ◽

Beka Behrens ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Sleep Apnea ◽

Amyloid Burden ◽

Obstructive Sleep

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The Prevalence of Obstructive Sleep Apnea in Mild Cognitive Impairment: A Systematic Review

10.21203/rs.2.9298/v1 ◽

2019 ◽

Author(s):

Talha Mubashir ◽

Lusine Abrahamyan ◽

Ayan Niazi ◽

Deween Piyasena ◽

Abdul A. Arif ◽

...

Keyword(s):

Systematic Review ◽

Obstructive Sleep Apnea ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Sleep Apnea ◽

Diagnostic Methods ◽

Patient Recruitment ◽

Prevalence Rates ◽

Community Based ◽

Obstructive Sleep

Abstract Background: Previous studies have shown that obstructive sleep apnea (OSA) is associated with a higher risk of cognitive impairment or dementia in the elderly, leading to deleterious health effects and decreasing quality of life. This systematic review aims to determine the prevalence of OSA in patients with mild cognitive impairment (MCI) and examine whether an association between OSA and MCI exists. Methods: We searched Medline, PubMed, Embase, Cochrane Central, Cochrane Database of Systematic Reviews, PsychINFO, Scopus, the Web of Science, ClinicalTrials.gov and the International Clinical Trials Registry Platform for published and unpublished studies. We included studies in adults with a diagnosis of MCI that reported on the prevalence of OSA. Two independent reviewers performed the abstract and full-text screening, data extraction and the study quality critical appraisal. Results: Five studies were included in the systematic review. Overall, OSA prevalence rates in patients with MCI varied between 11−71% and were influenced by OSA diagnostic methods and patient recruitment locations (community or clinic based). Among studies using the following OSA diagnostic measures– self-report, ApneaLink, Berlin Questionnaire and polysomnography– the OSA prevalence rates in MCI were 11%, 27%, 59% and 70%, respectively. In a community-based sample, the prevalence of OSA in patients with and without MCI was 27% and 26%, respectively. Conclusions: Based on limited evidence, the prevalence of OSA in patients with MCI is 27% and varies based upon OSA diagnostic methods and patient recruitment locations. Our findings provide an important framework for future studies to prospectively investigate the association between OSA and MCI among larger community-based cohorts and implement a standardized approach to diagnose OSA in memory clinics. PROSPERO registration: CRD42018096577

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