by Antonella Sparvoli
There is now various evidence that correlates this disorder, often underestimated, with cognitive deficits. So far, the increased risk has been proven, especially in relation to cardiovascular diseases
The phenomena of oxygen deficiency (hypoxia) that occur intermittently in those suffering from sleep apnea can interfere with the expression of numerous genes during the day, including those of our biological clock, with “time” and “tissue” variations specifications. This is suggested by a study published in the journal Plos Biology, conducted on an animal model of obstructive apnea. The research found that the greatest changes in gene activity were observed in the lung and, to a lesser extent, in the heart, liver and cerebellum. According to scholars, the new data could help explain the organ damage that patients with untreated chronic sleep apnea may suffer.
How it manifests itself
This sleep breathing disorder can in fact have various consequences if not recognized and treated. «Sleep apnea syndrome is characterized by repeated episodes of complete (apnea) or partial (hypopnea) obstruction of the upper airways during rest, associated with decreased blood oxygenation (intermittent hypoxia) and sleep fragmentation — explains Luigi Ferini Strambi, head of the Sleep Medicine Center of the Irccs San Raffaele Hospital in Milan and professor of neurology at the Faculty of Psychology of the Vita-Salute San Raffaele University -. Reduced oxygenation can have negative repercussions on various organs and systems, starting from the cardiovascular system, increasing the risk of developing hypertension, atrial fibrillation, heart attack and stroke. Fragmented sleep, linked to continuous micro-awakenings, is instead the main cause of excessive daytime sleepiness which exposes one to a greater risk of car accidents (2 to 7 times more), work and home accidents”.
Greater risk of dementia
Not only that, recent studies suggest that sleep apnea is also related to a greater risk of dementia and French research, published in the journal Neurology, brings new data in favor of this hypothesis, highlighting a relationship between sleep apnea and reduction in brain volume. The study compared people with amyloid plaques in the brain, an early sign of Alzheimer’s disease, but still without memory problems, with people who did not have them. The data collected shows that individuals with amyloid plaques with more severe sleep apnea were also more likely to have smaller volumes in the medial temporal lobe area of the brain, including the hippocampus, which plays an important role in memory and is involved in Alzheimer’s.
Individuals who did not have amyloid plaques did not have a reduction in brain volume, even if they had severe sleep apnea. These observations suggest that some people, particularly those in the very early stages of Alzheimer’s, are more vulnerable to the negative effects of sleep apnea, which over time could increase their chances of experiencing memory deficits.
The effects on cognitive abilities and nervous degeneration
Furthermore, the French researchers hypothesize, treating apnea could improve cognitive abilities and delay nerve degeneration. «The risk of cognitive deficits and dementia associated with sleep apnea seems to be more related to hypoxia than to sleep fragmentation, as demonstrated by prospective studies – observes Ferini Strambi -. We ourselves have highlighted, in people who suffered from severe sleep apnea, a reduction in the volume of the cerebral cortex in various areas, an event that was correlated with a cognitive deficit in several tests. The interesting aspect is that this process appears to be reversible. The use of CPAP, a ventilation device to be used at night to treat apnoea, led to a normalization of the volumes of the cortex after three months. Diagnosing sleep apnea early and treating it appropriately therefore also seems useful for delaying or preventing neurodegeneration.” There are various strategies that can be adopted to combat sleep apnea, from weight loss to surgery in very selected cases, the important thing is to promptly recognize the disorder.
How can you realize that you are suffering from it
«Snoring is the typical alarm bell of a partial obstruction of the airways and generally precedes the onset of episodes of complete apnea by years. Often those who suffer from this disorder do not notice anything and it is their partner who detects the breathing pauses” reports Ferini Strambi. «Alongside snoring, there are also other symptoms suggestive of the presence of sleep apnea starting from restless night sleep and the need to often get out of bed during the night to go and urinate. Other warning signs are excessive night sweating and waking up with a feeling of suffocation as well as daytime symptoms such as the sensation of non-restorative sleep, easy tiredness and excessive daytime sleepiness. «Sleep apnea syndrome can also cause reduced libido and sexual impotence, short-lasting headache upon awakening, memory, concentration and attention problems, sometimes depressive symptoms».
Treatment of sleep apnea
CPAP is the most widespread and effective treatment for sleep apnea syndrome and is based on the use of continuous positive pressure mechanical ventilation devices during the night. In practice, you wear a mask, preferably a nasal one, connected to a compressor that pushes air into the upper airways, thus avoiding both snoring and apnoea. However, there are also other strategies, starting with weight loss and positional therapy. «In those who are overweight and have mild forms of apnea syndrome, losing weight also involves a reduction of fat in the upper respiratory tract, counteracting respiratory obstruction during sleep – explains Ferini Strambi -. Positional therapy instead consists of inducing the individual to sleep on the side with various methods (for example by sewing a pocket on the back of the pajamas in which to insert a tennis ball) and is indicated when the patient has apnea when sleeping on his stomach ».
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January 28, 2024 (changed January 28, 2024 | 08:35)
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