Connections Between Sleep Apnea & Dementia (and Alzheimer’s Disease)

added on: July 25, 2022
Baby Boomers is a term used to describe a population surge of those who were born post-WW II between the years 1946 – 1964. Starting in 2030, all “boomers” will be older than 65, making up 21 percent of the population (up from 15 percent at present).
This gives the U.S. quite a challenge. By 2060, nearly one in four Americans will be 65 years and older. Seniors over the age of 85 will have tripled, with half million adults having reached age 100-plus.
Aging adults are now more health conscious than in prior years. They have become more aware of the repercussions of smoking, alcohol, inactivity, poor diets, and recreational drugs. Annual screenings are now deemed an important part of prevention or “catching” problems in early stages.
Although many are committed to living healthier lives, there are inevitable things that simply come with the aging process.
In earlier articles, you probably read my cautions about oral dryness, which is a natural occurrence for aging adults. The benefits of keeping natural teeth have also been addressed, as have the associations between severe health problems (such as heart attack and stroke) and the bacteria of gum disease. Our oral health has clearly shown to have an affect on overall health.
Here, I’d like to share some concerns of dementia and its most dreaded form, Alzheimer’s disease.  To be clear, dementia is a decline in memory or brain function that is more dramatic from what is considered a normal decrease in short-term memory. Alzheimer’s disease is a progressive disorder that leads to memory loss and basic cognitive abilities, such as thinking skills, judgment, and reasoning.
Dementia is caused by changes in the brain which impact cognitive function. Alzheimer’s disease, the most common type, now impacts over 10% of U.S. adults ages 65-plus who suffer from dementia. For those 85 or older, this number rises to over 33%.
Although any adult over the age of 65 will admit to having a “senior moment” occasionally, it’s important to react to issues that may create (or reveal) risks without delay.
The brain needs a certain amount of oxygen every minute. If oxygen levels in the blood are not enough, the body may increase blood flow to compensate. If this is still not enough, the brain reacts with immediate signs that may include:
• Difficulty with complex tasks
• Poor short-term memory capacity
• Decreased motor control
• Increased heart rate
• Fainting
Even after the person’s oxygen supply is returned to normal, if oxygen deprivation has occurred, the risk of dementia’s onset remains.
If a person facing low levels of oxygen is restored to adequate levels fast enough, the damage may be minimal or reversible. But if the damage is long-term and causes dementia onset, there is little that can be done short of managing the symptoms.
Obstructive Sleep Apnea (OSA) is a common sleep disorder, affecting about 1 billion people worldwide. It is caused by the collapse of the airway during sleep, resulting in intermittent dips in oxygen levels and arousals from sleep.
A recent study on sleep apnea (published in the Journal of Alzheimer’s Disease) reported that severe OSA is linked to an increase in a protein that accumulates on arterial walls in the brain, leading to an increased risk of dementia.
The study included 46 adults: 34 with untreated OSA and 12 who were without sleep disorder indications. Researchers tracked associations between this particular brain protein through PET brain scans, along with measures of sleep, demographics and mood.
The OSA group recorded a higher amyloid burden, poorer sleep efficiency and less time spent in the REM sleep stage. During this stage of sleep, the brain is actually very active, resetting its “checks and balances”. This allows the body to regenerate the ability to heal and repair itself.
Although more research is needed, the study further exposed the urgency of treating OSA to help reduce dementia risk. This disorder can also lead to higher risks of heart disease, stroke, high blood pressure, obesity, and Type 2 diabetes.
Common symptoms of sleep apnea include daytime fatigue, lack of alertness, reduced energy, nodding off easily (even behind the wheel), feeling hungry more often, and being more accident prone.
The challenge is early diagnosis. Many people write their symptoms off to stress, a bad mattress, or their own sleep disruption from heavy snoring.
For some people who suspect sleep apnea, there also may be a fear how having to sleep in a CPAP device. These typically consist of a mask with an attached hose that is connected to a fan. The fan pushes air through the hose and into the airway passages. However, compliance of wearing sleep apnea devices is low with complaints ranging from noisiness, not being able to move around in bed, embarrassment, and feeling claustrophobic.
Fortunately, there are ways to overcome these obstacles. Today, diagnosis can be done through an at-home test that is read by a Sleep Medicine physician. Too, treatment may not require you to wear a CPAP device.
For people who have mild to moderate levels of sleep apnea, a small, custom-made oral appliance may be an effective solution.
Using our Cone Beam 3D technology, the imaging provides the ability to detect blockages in airway passages. In our Shelby Township dental office, our patients are also provided with the advanced skills of a neuromuscular dentist.
To avoid the need for a CPAP, true assessment of the factors related to obstructive sleep apnea may reveal the lesser requirement for a custom-made oral appliance. The neuromuscular approach to treating sleep apnea (as well as most TMJ disorders) is the reason some patients come to our Macomb County MI office from out-of-state.
When it comes to treatment, not all oral appliances are alike. There is a significant difference in what one dentist may create  based on contours assessed while reclined in a treatment chair, and our properly-contoured appliances. The individualized approach we take can make the difference between a truly effective device and one that helps somewhat.
If you suspect sleep apnea or snore loudly, we urge you to schedule a free consultation as soon as possible. This condition will not improve on its own, and may worsen. Begin by calling our Shelby Township dental office at 586-739-2155 or tap here to begin.
You may also want to take our online sleep test at:

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Dr. Ban R. Barbat

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