Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018;64(s1):S255-S270.
doi: 10.3233/JAD-179936.

The Relationship between Obstructive Sleep Apnea and Alzheimer's Disease

Andreia G Andrade  1   2 , Omonigho M Bubu  3 , Andrew W Varga  4 , Ricardo S Osorio  2   5
Affiliations
Review

The Relationship between Obstructive Sleep Apnea and Alzheimer's Disease

Andreia G Andrade et al. J Alzheimers Dis. 2018.

Abstract

Obstructive sleep apnea (OSA) and Alzheimer's disease (AD) are highly prevalent conditions with growing impact on our aging society. While the causes of OSA are now better characterized, the mechanisms underlying AD are still largely unknown, challenging the development of effective treatments. Cognitive impairment, especially affecting attention and executive functions, is a recognized clinical consequence of OSA. A deeper contribution of OSA to AD pathogenesis is now gaining support from several lines of research. OSA is intrinsically associated with disruptions of sleep architecture, intermittent hypoxia and oxidative stress, intrathoracic and hemodynamic changes as well as cardiovascular comorbidities. All of these could increase the risk for AD, rendering OSA as a potential modifiable target for AD prevention. Evidence supporting the relevance of each of these mechanisms for AD risk, as well as a possible effect of AD in OSA expression, will be explored in this review.

Keywords: AD risk; Alzheimer’s disease; OSA phenotypes; amyloid; obstructive sleep apnea.

PubMed Disclaimer

Figures

Figure 1:
Figure 1:
Proposed prevalence of OSA age-phenotypes. Age-Related OSA would be more common in younger subjects, with its prevalence stabilizing in older age. Age-Dependent OSA prevalence would start to increase in older ages, contributing to the higher prevalence of OSA in this age group.
Figure 2:
Figure 2:
Possible intermediate mechanisms in the relationship between OSA and AD. The effect of OSA in increasing the risk for AD can be mediated by several of its associated mechanisms. Chronic exposure to intermittent hypoxia may lead to increased inflammation and oxidative stress, diabetes, hypertension and CVD, all potentially contributing to AD pathology development. Sleep fragmentation, both by itself and by leading to decreased REM and SWS stages, can additionally promote AD pathogenesis. Finally, intrathoracic pressure swings associated with OSA may disrupt CSF-ISF exchange integrity and lead to AD neuropathology accumulation. OSA: Obstructive Sleep Apnea; CVD: Cardiovascular Disease; REM: Rapid Eye Movement; SWS: Slow Wave Sleep; CSF-ISF: Cerebrospinal Fluid-Interstitial Fluid; AD: Alzheimer’s Disease.
See this image and copyright information in PMC

References

    1. Remmers JE, deGroot WJ, Sauerland EK, Anch AM (1978) Pathogenesis of upper airway occlusion during sleep. J. Appl. Physiol 44, 931–938. - PubMed
    1. Sanchez-de-la-Torre M, Campos-Rodriguez F, Barbe F (2013) Obstructive sleep apnoea and cardiovascular disease. Lancet Respir. Med 1, 61–72. - PubMed
    1. Morgenthaler TI, Kagramanov V, Hanak V, Decker PA (2006) Complex sleep apnea syndrome: is it a unique clinical syndrome? Sleep 29, 1203–1209. - PubMed
    1. Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK, Marcus CL, Mehra R, Parthasarathy S, Quan SF, Redline S, Strohl KP, Ward SLD, Tangredi MM (2012) Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J. Clin. Sleep Med. JCSM Off. Publ. Am. Acad. Sleep Med 8, 597–619. - PMC - PubMed
    1. Guilleminault C, Partinen M, Quera-Salva M, Hayes B, Dement WC, Nino-Murcia G (1988) Determinants of daytime sleepiness in obstructive sleep apnea. Chest 94, 32–7. - PubMed

Publication types

MeSH terms