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Can Sleep Apnea Cause Brain Damage

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Can Sleep Apnea Cause Brain Damage

KCNC-CBS Denver – Sleep Apnea Can Damage the Brain

Those living with any form of sleep apnea may have many questions regarding the relationship it has with their brain, such as can sleep apnea cause confusion? and can you get brain damage from sleep apnea?

First, its important to understand how sleep apnea impacts the brain in the long run. One of the biggest risks of untreated sleep apnea is low blood oxygen levels. In cases of Obstructive Sleep Apnea, collapsed tissue in the back of the throat can block the upper airway, which restricts the flow of oxygen in the blood. Similarly, Central Sleep Apnea involves frequent stops and starts in breathing, causing your oxygen levels to drop whenever you experience a pause in breathing while you sleep.

Without an adequate supply of oxygen, the brain can suffer in many ways. Oxygen is essential to proper brain growth and healing. If the flow of oxygen to the brain is disrupted in any way, it may cause long-term damage that can compromise your overall health and well-being. Some of the most common brain damage symptoms include weakness, extreme fatigue, headaches, tremors, confusion, and seizures.

Weaker Brain Blood Flow Response In Osa Patients

For their latest study, Macey and colleagues measured brain blood flow in sleep apnea patients using a non-invasive MRI procedure called the global blood volume and oxygen dependent signal.

They explain that this method is typically used to examine brain activity, and since previous research showed that sleep apnea sufferers often have poor regulation of blood in the brain, they used the whole-brain BOLD signal to observe blood flow in participants with and without OSA.

We know there is injury to the brain from sleep apnea, says Macey, and we also know that the heart has problems pumping blood to the body, and potentially also to the brain. He explains that by using the BOLD method, they were able to observe changes in oxygenated blood amounts throughout the whole brain.

Participants from the study, which included both men and women with and without OSA, had their BOLD signals measured while they were awake during three physical tasks:

  • The Valsala maneuver, in which they breathed out forcefully through a small tube that raises the pressure in the chest
  • A hand-grip challenge, in which the participants squeezed hard with their hand
  • A cold-pressor challenge, in which the participants right foot was placed in icy water for 1 minute.

They add that because changes from the Valsala maneuver are mainly driven by blood pressure signaling in the chest, it does not require the muscle-controlling parts of the brain.

How Sleep Apnea May Damage Brain Function

Those who suffer from obstructive sleep apnea often struggle with symptoms like difficulty concentrating, remembering things, making decisions and reacting to situations. People may also experience mood changes associated with sleep apnea, such as irritability, increased stress, anxiety and depression.

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How Does Sleep Apnea Affect The Quality Of Memory

If You Have Sleep Apnea, Your Memory May Decline Earlier in Life Study links sleep breathing problems, cognitive loss Sleep apnea a sleep disorder in which breathing is briefly and repeatedly interrupted during sleep may be doing more than affecting the quality of your sleep and making you tired.

Effects Of Severe Sleep Apnea On The Brain

Treating sleep apnea reverses brain damage

by Gingras Sleep Medicine | Nov 2, 2018 | Sleep Apnea

As they lay their head down to rest each night, 25 million American adults struggle with sleep apnea a sleep disorder that involves the temporary, and repetitive interruption of breathing.

Deriving its name from the Greek word for without breath, obstructive sleep apnea is a destructive disease that can be debilitating for health and may even increase your risk of death, according to the American Academy of Sleep Medicine .

Causing a host of symptoms during shuteye, the condition is marked by gasping, snoring and choking or silent breathing pauses throughout sleep, which can be disturbing for both sufferers and their partners.

But the symptoms dont stop when you wake. A lack of restorative slumber can lead to daytime sleepiness, memory problems, depression, and anxiety. Every time breathing ceases during the night, victims of obstructive sleep apnea experience a drastic drop in oxygen levels that damage the bodys cells.

A study conducted by Sleep journal found that both gray and white matter are diminished in the brains of subjects with this sleep disorder. To put it simply, the central nervous system is divided into two main areas , with processing done in the gray area, while the white matter allows for communication between gray matter regions.

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How Can Sleep Apnea Cause Brain Damage

Brain damage is any trauma that impairs the brains ability to function in the short term, or in severe cases, long-term. If your airway gets obstructed or closes entirely, air cannot reach your lungs, inhibiting oxygen from reaching your body and therefore your brain. Our bodies and brains depend on oxygen to stay alive, and without it, our brain cells become damaged or even die.

With sleep apnea, the lack of oxygen causes our heart rate to slow down and decreases blood and oxygen flow. When we finally take another breath, our heart begins to race to push oxygen to the rest of our organs only to be cut off as the airway again closes. This continuous speeding up and slowing down of the heart is like a nightly marathon for your body without the oxygen available to support it. At this point, cells begin to become damaged and die, causing brain damage.

Restoring Sleep Apnea Brain Damage

Fortunately, according to some studies, it is quite possible to reverse the damage done to the brain by sleep apnea. While the likelihood of a full cure varies from patient to patient, there are many ways to restore good health and functionality to your brain.

The most common and beneficial treatment is to use a CPAP, which is a machine that you use while you sleep. Research shows that people who use CPAP treatment for a year can improve and regrow the white matter in their brain, getting rid of the damages.

Not to mention, CPAP treatment can help eliminate other symptoms of the condition as well. You will breathe better, sleep easier, and supply more oxygen throughout your body.

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How Brain Damage Caused By Sleep Apnea Can Be Reversed

There is good news from all this research as well. According to the American Academy of Sleep Medicine, the negative effect that OSA may have on the brain can actually be stopped and reversed. With proper treatment, the brain has proved to be quite resilient. CPAP therapy has been shown to effectively treat obstructive sleep apnea. And, over the course of one year, CPAP therapy helped to reverse visible damage to the brain and significantly improve nearly all the symptoms related to cognitive ability and mood.

Sleep Apnea And Alzheimer’s Disease

Not enough sleep can damage your brain

Without CPAP therapy, sleep apnea can potentially contribute to serious neurological conditions. Untreated sleep apnea is associated with a higher risk of developing Alzheimers disease. In fact, one 2020 study found that sleep apnea-related sleep damage started in the same place and spread in the same way as Alzheimers disease.

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Areas Of Brain Damaged By Sleep Apnea

We know that sleep apnea can cause brain damage, but how much damage can it actually cause? Sleep apnea can actually affect several different regions in the brain, leading to widespread brain damage.

There are five common areas of the brain that are damaged by sleep apnea.

1. Mammillary bodies: Mammillary bodies are actually located on the underside of the brain. They are associated with memory. They can be up to 20% smaller in people with sleep apnea. Damage to mammillary bodies can result in memory loss and forgetfulness.

2. Hippocampus: The hippocampus is not only one of the regions damaged in Alzheimers disease but it can also be damaged by sleep apnea. This region of the brain is responsible for processing information and memory.

3. Cerebellum: The cerebellum is responsible for controlling motor coordination and blood pressure regulation. It can also play a part in language, attention, and other cognitive functions.

4. Insular cortex: The insular cortex is responsible for wide-ranging cognitive functions. It plays a part in regulating our nervous system and controls our pain receptors. It also plays a role in our emotions and mood, affecting how we feel.

5. Ventrolateral medulla: This region of the brain regulates our blood pressure. When it is damaged, the result can be cardiac problems, including heart arrhythmia, problems with heart rate rhythm, and other potentially serious symptoms.

Brain Damage From Sleep Apnea Is Reversible

    Sleep apnea: We know it keeps us up at night by waking us repeatedly. We even know that it causes snoring, gasping and choking for air. But did you know that sleep apnea has been found to cause brain damage, too? Thats right all that stopping and restarting of breathing cuts off oxygen to the brain, which in turn causes damage to both gray and white matter in the brain.

    Dr. James Block treats sleep apnea in his Fremont, California, clinic. He says this damage translates to impaired cognition during the day, as well as diminished alertness, affected mood and even lethargy.

    The news comes on the heels of a study by the Sleep Disorders Center at San Raffaele Hospital and Vita-Salute San Raffaele University in Milano, Italy, that revealed that both types of brain matter are adversely affected by the disorder.

    But there is good news. A second study by the same team revealed that the brain damage is reversible with treatment.

    The first study conducted by the Sleep San Raffaele University found that damage to gray matter could be repaired at around the third month of sleep therapy, and that at the one-year mark can be completely restored, says Block.

    The second study found the same results occurred in white matter, but that white matter is more difficult to repair than gray matter.

    The white matter took a bit longer to be restored, Block says. But it was reparable when patients stuck with their treatment plan.

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    Understanding The Link Between Sleep Apnea And Brain Damage

      According to the American Academy of Sleep Medicine, about 26 percent of U.S. adults are living with sleep apnea. Many with sleep apnea do not receive the proper treatment. Untreated sleep apnea is often associated with a number of serious health problems, such as Type 2 diabetes, heart disease, and stroke. However, a lesser-known risk of this sleep apnea is brain damage. If youre wondering, can you get brain damage from sleep apnea, here is everything you need to know.

      When To See A Doctor

      5 Areas of Brain Damage Caused By Obstructive Sleep Apnea ...

      According to the Mayo Clinic, you should consult a medical professional if you or your partner observes the following:

      • Snoring loud enough to disturb the sleep of others or yourself
      • Shortness of breath that awakens you from sleep
      • Intermittent pauses in your breathing during sleep
      • Excessive daytime drowsiness, which may cause you to fall asleep while you’re working, watching television or even driving

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      What Are The Symptoms Of Sleep Apnea Induced Brain Damage

      Those who suffer from brain damage caused by sleep apnea may experience a wide range of symptoms. These symptoms can target many different areas of the body, including the bones, digestive system, and nervous system. In addition, some people find that they suffer a number of cognitive symptoms after experiencing sleep apnea induced brain damage.

      Some of the most common sleep apnea and brain damage symptoms include the following:

      • Temporary Loss of Consciousness
      • Difficulties With Balance
      • Blurred Vision

      If you recognize any of these symptoms in yourself, its crucial to seek out the help you need as soon as possible.

      Sleep Apnea Is Theorized To Impact Neural Repair And Neurodegeneration In Brain Injury

      Animal and human studies have shown that sleep-wake cycle disturbances may alter neurotransmitters and receptor systems, neuronal activation and related signaling molecules, as well as physical functioning, mood, cognition and behavior.3-6 Zunzunegu and colleagues demonstrated the moderating effects of sleep on several endogenous brain repair mechanisms in an animal model of brain injury.7 Following lesion placement, an experimental group was deprived of sleep during recovery and performed significantly worse on behavioral tasks compared to a control group allowed to sleep during recovery.7 Following autopsy, the group deprived of sleep had significantly lower amounts of indices of brain repair including axonal sprouting, synaptogenesis, and vasogenesis compared to the control group allowed to sleep.7

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      Evidence That Obstructive Sleep Apnea Causes Brain Damage

      Studies show that obstructive sleep apnea affects much more than just your sleep. It can even damage your brain.

      A recent brain imaging study from France involved 16 adults. Each of them had just been diagnosed with sleep apnea.

      In numerous brain regions the study found a loss of gray matter. This is brain tissue that contains fibers and nerve cell bodies. There also was a decrease in brain metabolism.

      The authors suggest that these changes may explain some of the impairments that often occur in people with sleep apnea. Examples include attention lapses and memory loss. The study was published in the March 2009 issue of the Journal of Sleep Research.

      The results are similar to those found by a research team from UCLA. Their study was published in Neuroscience Letters in June 2008.

      They reported that people with sleep apnea have tissue loss in the mammillary bodies. These are brain regions that help store memory.

      In July 2008 the UCLA team published another brain imaging study in the journal Sleep. It involved 41 people with moderate to severe sleep apnea. It also included 69 control subjects matched by age.

      Results show that people with sleep apnea have extensive alterations in white matter. This is nerve tissue in the brain. It contains fibers that are insulated with myelin a white, fatty sheath.

      What causes the brain damage? The authors suggest that oxygen, blood flow and blood pressure may be involved.

      What Kinds Of Brain Damage Happen With Sleep Apnea

      Sleep Apnea, Causes,Signs and Symptoms, DIagnosis and Treatment.

      Studies have shown that long-term sleep apnea leads to changes in the volume of many different parts of the brain, including both the gray matter and the white matter . Because the brain is believed to repair itself during sleep, it makes sense that sleep deprivation would lead to damage to the brain over time.

      Patients with sleep apnea often notice changes such as impaired memory, depressed mood, and inability to concentrate. These are a result of the effects of OSA on the brain.

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      Can Sleep Apnea Cause Mental Confusion

      Sleep apnea is also associated with trouble concentrating, memory problems, poor decision-making, depression and stress. For the study, the researchers examined levels of two brain chemicals: glutamate and gamma-aminobutyric acid, also known as GABA. These chemicals are found in a part of the brain called the insula.

      What Else Does Sleep Apnea Affect

      Along with affecting our oxygen levels, sleep apnea also affects the chemical levels in our brain. Glutamateone of the brains chemicals used to keep humans calmincreases as the heart races to push blood to the organs during the ebb and flow of oxygen caused by sleep apnea. This can cause toxic reactions and damage to your nervous system.

      The white matter parts of your brain help control mood and memory. When oxygen is in short supply, these white matter sections of your brain get damaged and can lead to memory, mood, and emotional problems.

      Memory loss and dementia can also be side effects of sleep apnea. Along with the issues mentioned above, a nightly lack of oxygen can make it difficult for the brain to convert short-term memory into long-term memory. Over time, this level of oxygen deprivation can lead to brain cell loss, atrophy, and even dementia.

      According to Jessica Kepplinger, who led a Dresden University study, nearly every patient that was the victim of a stroke had sleep apnea. In fact, only nine percent of stroke patients evaluated did NOT have sleep apnea.

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      Areas Of Brain Damage Caused By Obstructive Sleep Apnea

      One of the most common complaints by my patients with obstructive sleep apnea is memory loss. Judith is a 55 year old woman who used to have a sharp memory, but now is having trouble with names and losing her keys all the time. Things got much worse when she gained more weight, which worsened her snoring. She was eventually placed on CPAP for her moderate obstructive sleep apnea, and is now happy to report that while her memory is not back to normal, it is much improved.

      At a recent Airway Dentistry conference I went to last month, the most memorable topic was given by Dr. Ronald Harper, Distinguished Professor of Neurobiology at the David Geffen School of Medicine at UCLA. Ive been following his work over many years, but his presentation only confirmed my suspicion that there can be significant brain damage with untreated obstructive sleep apnea. Based on various high-tech MRI technology, specific known areas of the brain can be damaged with repeated episodes of apneas and low oxygen levels. Note that the word damage can mean low functioning, or dead brain cells. Here are 5 particular areas of brain damage from untreated obstructive sleep apnea with their specific symptoms:

      3. The cerebellum is the area of the brain that helps adjust blood pressure control and motor coordination, including breathing. Damage to this area prevents the ability to coordinate vascular and motor activity.

      References

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