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Review
. 2019 Jan 15;199(2):142-148.
doi: 10.1164/rccm.201801-0204PP.

Obstructive Sleep Apnea and the Risk of Cognitive Decline in Older Adults

Nadia Gosselin  1   2   3 , Andrée-Ann Baril  1   2   3 , Ricardo S Osorio  4   5 , Marta Kaminska  3   6 , Julie Carrier  1   2   3
Affiliations
Review

Obstructive Sleep Apnea and the Risk of Cognitive Decline in Older Adults

Nadia Gosselin et al. Am J Respir Crit Care Med. .
No abstract available

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Figures

Figure 1.
Figure 1.
Schematic representation of possible mechanisms linking obstructive sleep apnea to dementia. Obstructive sleep apnea leads to intermittent hypoxemia and changes in sleep macro- and microarchitecture. Intermittent hypoxemia probably causes systemic and brain responses that include metabolic disturbances/diabetes, oxidative stress, inflammation, hypertension, blood–brain barrier dysfunctions, and brain edema. These responses, combined with the altered sleep macro- and microarchitecture, may lead to small-vessel disease, microinfarcts, strokes, reduced neurogenesis, reduced synaptic plasticity, decreased cognitive functioning, changes in brain white and gray matter, changes in cerebral networks, and abnormal levels of Alzheimer’s disease biomarkers, which can all be involved in abnormal cognitive decline and dementia. Mechanisms in yellow boxes/dashed rectangle may all interact to create a vicious cycle; they also have the potential to alter sleep architecture and play a role in the systemic and brain responses to hypoxemia.
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