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Can sleep problems lead to the most common form of dementia?

Scientists have long suspected a link between obstructive sleep apnea and the disease that robs patients of memory: Alzheimer’s.

Now, they have visual evidence in the brain.

Plaques and tangles are the hallmark sign of Alzheimer’s disease. Now scientists have visual evidence they also exist in some patients with sleep apnea — a serious condition that occurs when a person’s breathing is repeatedly interrupted during sleep.

Dr Smita Patel is a neurologist with NorthShore University HealthSystem.

“In prior research studies, we weren’t able to directly make that link or association,” Patel said. “Of course we suspect when you don’t breathe and you don’t have oxygen and that is going to do something to your brain cells, especially when you wake up and you can’t remember or you feel tired during the day.”

Looking more closely at the brain tissue of sleep apnea patients, researchers in Australia and Iceland found the more severe the sleep apnea, the more buildup of amyloid plaque in the hippocampus – that’s the memory center in the brain. The interruption in sleep interrupts important processes in the brain – like toxin removal.

“It’s something to take seriously,” Patel said. “Especially if you don’t want to be going down the path of having memory problems later in life.”

And while the study’s authors noted the common treatment for sleep apnea, continuous positive air pressure or CPAP, did not appear to reduce damage, doctors say it’s a critical factor for prevention.

“I do think the treatment for sleep apnea using the CPAP machine, especially if you have a moderate or severe degree of sleep apnea, is still going to be important,” Patel said.

The patients in the study showed no clinical symptoms of dementia before they died, suggesting they may have been in an early pre-dementia stage.

“We want to try to catch you early. We don’t want to wait until you have symptoms like, ‘I can’t remember who my children are,’ or ‘Where my things are in the house?’” Patel said. “So we don’t want it to progress to that extent before you start treating your sleep apnea.”

There’s already evidence insomnia plays a role when it comes to dementia. The researchers would like to conduct a larger clinical trial for sleep apnea and hope their findings will eventually lead to new treatment targets to help prevent Alzheimer’s.