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Understanding the Association Between Obstructive Sleep Apnea Treatment and Dementia Risk: Galit L. Dunietz, PhD, MPH

The assistant professor of neurology at the University of Michigan provided context on a previous study which suggested that treatment of obstructive sleep apnea may reduce the risk of subsequent dementia. [WATCH TIME: 3 minutes]

WATCH TIME: 3 minutes

"There are biological pathways between sleep and dementia. We need to know more about the other dimensions of sleep—the timing of sleep, the quality of sleep, variability of sleep—and how these patterns relate to dementia and cognitive decline. That’s the first thing we don’t know."

Sleep disturbances, as well as sleep-wake rhythm disturbances, are typical symptoms of Alzheimer disease (AD) that may precede the other clinical signs of this neurodegenerative disease. There is accumulating evidence suggesting that disordered sleep contributes to cognitive decline and the development of AD pathology. One such study, published in 2021, examined the associations between positive airway pressure (PAP), the standard therapy for obstructive sleep apnea (OSA), adherence and incident diagnoses of AD, mild cognitive impairment (MCI), and dementia not otherwise specified (DNOS) in older adults.1

Led by Galit L. Dunietz, PhD, MPH, the retrospective study used Medicare claims data for 53,321 beneficiaries aged 65 and older with an OSA diagnosis prior to 2011. Using International Classification of Diseases criteria, a total of 1057, 378, and 443 individuals with AD, DNOS, and MCI, respectively, were identified between 2011 and 2013. In total, 78% of the beneficiaries with OSA were prescribed PAP, and 74% showed evidence of adherent PAP use. In unadjusted models, PAP treatment was found to be associated with a lower odds of incident diagnoses of AD (odds ratio [OR], 0.78 [95% CI, 0.69-0.89] and DNOS (OR, 0.69; 95% CI, 0.55-0.85). Additionally, PAP adherence was associated with lower odds of incident diagnoses of AD (OR, 0.65; 95% CI, 0.56-0.76).1

Dunietz, an assistant professor in the Department of Neurology and Division of Sleep Medicine at the University of Michigan, has been a leader within the sleep research space, especially when it comes to understanding insomnia and cognitive health. After giving a presentation on the interplay between menopause, insomnia, and cognitive health, Dunietz sat down with NeurologyLive® at the 2022 SLEEP Annual Meeting, June 4-8, in Charlotte, North Carolina, to discuss the importance of her previous findings and the significance of adhering to OSA treatment. Additionally, she discussed the research still needed to understand the correlations between sleep and dementia risk.

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REFERENCES
1. Dunietz, GL, Chervin RD, Burke JF, Conceicao AS, Braley TJ. Obstructive sleep apnea treatment and dementia risk in older adults. Sleep. 2021;44(9):zsab076. doi:10.1093/sleep/zsab076