26 Jul Obstructive Sleep Apnea May Accelerate Alzheimer’s Disease

MedicalResearch.com Interview with:

Dr. Bubu

O. Michael Bubu, M.D., M.P.H., C.P.H
Wheaton College

MedicalResearch.com: What is the background for this study?

• Obstructive Sleep Apnea (OSA) and Alzheimer’s disease (AD) are both chronic disease conditions that are highly prevalent, cause significant morbidity and mortality to those afflicted, and have an enormous socio-economic impact. Recent human and animal studies describe associations between Sleep Disordered Breathing (SDB) and Alzheimer’s Disease (AD). However, whether OSA accelerates longitudinal increases in amyloid (Aβ) burden in MCI patients is presently unclear.
• In this study, we examined the effect of Obstructive Sleep Apnea (OSA) on longitudinal changes in brain amyloid deposition, and Alzheimer’s disease (AD) Cerebrospinal fluid (CSF) biomarkers including CSF beta-amyloid 42 peptide (Aβ-42), CSF TAU protein, CSF phosphorylated TAU protein (PTAU) in Cognitive Normal (CN), Mild Cognitive Impairment (MCI) and AD elderly. Brain amyloid (Aβ) burden, CSF Abeta42 and tau proteins are biomarkers (measurable substances whose presence are indicative) of AD-associated pathologic changes in the brain.
• Data from 1639 subjects (516 CN, 798 MCI and 325 AD, mean ages = 74.4 ± 5.8; 73.4 ± 7.4 and 75.1 ± 7.8 respectively), in the Alzheimer’s disease Neuroimaging Initiative (ADNI) database was used. OSA was self-reported and participants were labeled OSA positive, or OSA negative (mean ages = 72.3 ± 7.1; and 73.9 ± 7.3 respectively). Statistical analyses were conductedto examine whether OSA positive compared to OSA negative participants experienced significant differences in the rate of change of AD biomarkers over time (mean = 2.52 ± 0.51 years) in each group (CN, MCI and AD). Both OSA positives and negatives were similar in age, APOE e4 status, and history of cardiovascular disease. The final models controlled for sex, body mass index (BMI), and Continuous Pulmonary Airway Pressure (CPAP) use.

MedicalResearch.com: What are the main findings?

Brain amyloid (Aβ) burden:

• Significant differences in the change in Aβ-42 volumes over time (mean = 2.52 ± 0.51 years) were observed and  bstructive Sleep Apnea subjects experienced faster increase in Aβ-42 over time in both the CN and MCI groups. No significant differences were seen in the AD group.

CSF Aβ-42, TAU and PTAU levels:

• Significant differences were observed in CSF Aβ-42, TAU and PTAU levelsover time (mean = 2.52 ± 0.51 years) and OSA participants experienced a faster decrease in CSF Aβ-42 and increases in TAU and PTAU volumes over time in both the CN and MCI groups. No significant differences were seen in the AD group

MedicalResearch.com: What should readers take away from your report?

–        Obstructive Sleep Apnea may accelerate progression and worsening of cognitive decline to AD

–        Screening for and prescribing treatment for OSA should be a priority, especially in MCI individuals as they are at a higher risk for Alzheimer’s disease

–        Clinical interventions aimed at  Obstructive Sleep Apnea, such as treatment with CPAP or dental appliances, in cognitive normal and MCI patients, could possibly mitigate or slow the progression of cognitive impairment to Alzheimer’s disease.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

–        Sleep fragmentation and/or intermittent hypoxia from OSA are likely candidate mechanisms

–        Further research examining mechanisms underlying these observed effects are needed. 

–        I have no disclosures

–        Study was done in collaboration with the Sleep and Alzheimer’s team at NYU

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

2017 AAIC abstract:

Omonigho Bubu, MD, MPH, et al. Effect of Obstructive Sleep Apnea (OSA) on Rate of Change of AD Biomarkers in Cognitive Normal, MCI and AD Elderly: Findings from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) Cohort. (Funder(s): Wheaton College Faculty Development Grant

https://www.alz.org/aaic/releases_2017/AAIC17-Tues-Briefing-Sleep.asp

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

Last Updated on July 26, 2017 by Marie Benz MD FAAD