Is a malfunction of autonomic neurons within the brainstem the cause of obstructive sleep apnea? If so, why are these neurons defective and what can we do to repair this? Is sleep apnea a cause of dementia? Is sleep apnea the cause of Alzheimer's Disease?
Doctors Answers (3)
Yes. Obstructive Sleep Apnea (OSA) is a neurological disease (disorder). As a neurologist I feel that all sleep disorders are neurological. Your suggestion that the apnea may be secondary to a malfunction of autonomic neurons in the brain stem may apply more to Central Sleep Apnea (CSA). One cause for CSA may be a malfunction of the respiratory center in the brain stem. This can be secondary to head injury, infection, stroke, toxic exposure or anything which can damage brain cells including OSA. Other causes or contributing factors to both CSA and OSA include slow circulation of blood as in heart disease and medications such as those for pain which dampen the function of the respiratory center or weaken the function of the nerve supply to the muscles in the throat which enhance the obstruction of airflow to the lungs. It is common for patients with untreated OSA to experience memory impairment which mimics Alzheimer's Disease. When the OSA is treated there is a slow return of memory function. The neurons of the brain are damaged by OSA as they are deprived of oxygen. The autonomic nervous system is severely impacted by sleep apnea. This becomes a vicious cycle.
No, sleep apnea is NOT a neurological disorder. That said, control of the airway muscles is neurological. But other factors play into it, including age, compliance of the airway, the structure of the airway, weight, etc. Sleep apnea is associated with many cardiovascular problems but not Alzheirmer's Disease. Sleep Apnea can impair cognition but usually to the extent of a "fogged brain"so that could possibly be interpreted as "dementia". In any event, if you or a loved one snores, stops breathing when asleep, you should seek evaluation for your/his/or her health.
Obstructive sleep apnea is due to neurotransmitters, such as serotonin and norepinephrine, which are produced in the brainstem, not working properly. These neurotransmitters control whether we are awake or asleep by acting on different parts of the brain. Sleep itself plays a role in the consolidation of long-term memory. Hypoxia-reduced oxygen to the brain-cased by the breathing disruptions is consistently associated with mental impairment. Sleep apnea and Alzheimer’s disease are 2 separate conditions which may still interact in the aged.