Sleep And Cognition

Sleep apnea linked to dementia in older women

A study recently published in JAMA, the Journal of the American Medical Association, by Kristine Yaffe, MD, of the University of California, San Francisco, reports that older women with sleep apnea have twice the risk of developing dementia as those without the breathing disorder, but the data weren't conclusive as to why.

Although she wasn’t involved in the study, Nancy Foldvary-Schaefer, DO, Director of the Sleep Disorders Center and Fellowship Program at Cleveland Clinic, agrees with the findings that people with sleep apnea should be screened for cognitive problems.

“This confirms lots of other work demonstrating the adverse consequences of untreated moderate to severe sleep apnea,” she says.

Treatment is Important

Sleep apnea, in which individuals stop breathing as many as hundreds of times a night, usually results from a blockage of the airway during sleep. The disorder is estimated to affect 10 percent to 20 percent of middle-aged and older adults, according to a recent report by the federal Agency for Healthcare Research and Quality.

“Sleep apnea does not cause dementia, but can produce cognitive problems that mimic some brain disorders,” says Dr. Foldvary-Schaefer. “Untreated sleep apnea has the potential to affect all aspects of cognition, which is especially important for people who are already affected by disorders characterized by cognitive decline.”

But a diagnosis of sleep apnea in older patients does not necessarily include reduced cognitive functioning, assures Dr. Foldvary-Schaefer. “Most patients report improvement in mood and cognition once moderate to severe sleep apnea is treated. For patients with significant cognitive complaints that do not improve with treatment of sleep apnea, further evaluation should be considered.”

Treatments for sleep apnea include devices that force oxygen up patients' airways, known as continuous positive airway pressure, or CPAP; oral devices placed in the mouth to prevent the blockage of the airway; and surgery. Among these treatments, the strongest evidence shows CPAP as effective, according to the Agency for Healthcare Research and Quality's report.

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