New Study Associates Obstructive Sleep Apnea with Changes in Brain Integrity

Sarasota, FL (WorkersCompensation.com) – Lack of sleep has been closely associated with both cognitive decline and workplace accidents. According to statistics cited by the Sleep Foundation, in 2017 it is estimated that at least 91,000 car crashes, 50,000 injuries, and 795 deaths were the result of driving while sleepy. By comparison, drunk driving was associated with only 9,949 crashes the same year.

Obstructive sleep apnea happens when the muscles in the back of the throat relax, narrowing or closing the airway and constricting breathing for 10 seconds or longer. This pattern of stopped breathing can occur 5 to 30 times or more an hour, disrupting sleep in the process. The result is a lower level of oxygen in the blood, and a buildup of carbon dioxide. Additionally, some studies have shown that patients with OSA experience excessive levels of sleepiness during the daytime even with appropriate therapy. Certain conditions have a greater risk of developing OSA, including obesity, aging, high blood pressure, chronic nasal congestion, smoking, asthma, and diabetes.

A collaborative study by researchers at University Ansan Hospital in South Korea, and Beth Israel Deaconess Medical Center located in Boston, Massachusetts suggests that OSA may not only impact cognitive function, but also the connectivity tissue known as “white matter” that drives visual processing and visual memory, as well as attention.

Researchers followed the middle-aged participants from 2011 to 2014, with follow up assessments occurring 2015 to 2018. The participants underwent high-level diffusion tensor imaging of the brain, overnight polysomnography, and neuropsychological assessments. The participant’s OSA conditions were assessed by comparing the polysomnography results, and then classed into four categories, OSA-free, resolved OSA, incident OSA, and persistent OSA. Participants with a history of neurological or psychiatric disorders, or those with structural issues such as history of stroke were excluded.

Out of the 1,110 participants reviewed, mild OSA was present in 44 percent. Of those, 69.1 percent had mild OSA, 25.6 had moderate OSA, and 5.3 percent had severe OSA, and only 6 had been treated with continuous positive airway pressure (CPAP) therapy during the study period. Those in the OSA group had a higher BMI levels, hypertension, and diabetes. Over the 4-year period, the incidence of OSA increased to 580 participants.

Both incident and persistent OSA groups had worse visual recognition, and even mild OSA was associated with substantial brain structure changes and function. Researchers noted an accelerated attention, visual processing, and visual memory decline, which was further supported by the white matter imaging scores.

Overall, the researchers found that OSA was associated with changes in white matter integrity, and cognitive performance. While researchers acknowledge the limitations of the study, they are hopeful the finding could offer potential targeted treatments in addressing brain health.

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