OBSTRUCTIVE SLEEP APNEA AS A MODIFIABLE RISK FACTOR FOR CEREBROVASCULAR DISORDERS: AN INTEGRATIVE PERSPECTIVE ON PREVENTION AND THERAPY
Keywords:
obstructive sleep apnea, neurodegeneration, cognitive impairment, stroke, glymphatic system, neuroinflammation, CPAP therapy, biomarkersAbstract
Obstructive sleep apnea (OSA) is recognized as an independent risk factor for the development of cognitive impairment. Recent evidence (Andreu et al., Sleep Medicine Reviews, 2024) [1]. indicates that intermittent hypoxemia associated with OSA contributes to structural alterations in the brain.The pathogenetic contribution of obstructive sleep apnea (OSA) to neurological diseases remains insufficiently recognized in daily clinical practice.
References
American Academy of Sleep Medicine. International Classification of Sleep Disorders, 3rd ed. 2023.
Heinzer R, et al. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med. 2023;11(3):285-297.
Osorio RS, et al. Sleep-disordered breathing advances cognitive decline in the elderly. Neurology. 2024;102(5):e892-e904.
Lee JJ, et al. Obstructive sleep apnea and risk of stroke: an updated systematic review and meta-analysis. Stroke. 2024;55(4):1019-1031.
Daulatzai MA. Evidence of neurodegeneration in obstructive sleep apnea: Relationship between obstructive sleep apnea and cognitive decline in the elderly. J Neurosci Res. 2023;101(4):443-465.
Nedergaard M, Goldman SA. Glymphatic failure as a final common pathway to dementia. Science. 2023;380(6640):eabb1849.
Lavie L. Oxidative stress in obstructive sleep apnea and intermittent hypoxia–revisited–the bad ugly and good: implications to the heart and brain. Sleep Med Rev. 2023;68:101746.
Zhang SX, et al. Sleep fragmentation promotes neuroinflammation and accelerates neurodegeneration in a mouse model of Alzheimer's disease. Brain Behav Immun. 2024;118:345-358.
Wen Q, et al. Association between sleep disorder and depression in stroke in the National Health and Nutrition Examination Surveys (NHANES) 2005 to 2014. Sleep Med. 2024;124:201-208.
Liguori C, et al. Obstructive Sleep Apnea is associated with early but not late amyloid-β deposition: A PET study. Ann Neurol. 2024;95(2):321-332.
Gitay A, et al. Spinocerebellar Ataxia-6 Associated with Sleep Behavior Disorder. J Assoc Physicians India. 2024;72(12):e62- e64.
Kim TJ, et al. Association of Obstructive Sleep Apnea with White Matter Integrity and Cognitive Profile. J Alzheimers Dis. 2023;94(1):245-256.
Henson J, et al. Sleep disorders in younger and middle-older age adults with newly diagnosed type 2 diabetes mellitus: A retrospective cohort study in >1million individuals. Diabetes Res Clin Pract. 2024;217:111887.
Lutsey PL, et al. Sleep-disordered breathing and midlife cognitive impairment: The Atherosclerosis Risk in Communities (ARIC) study. JAMA Neurol. 2023;80(8):844-853.
Bubu OM, et al. Obstructive sleep apnea, cognition and Alzheimer's disease: A systematic review integrating three decades of multidisciplinary research. Sleep Med Rev. 2024;71:101823.
Küçükali Cİ, et al. Distinctive sleep complaints and polysomnographic findings in antibody subgroups of autoimmune limbic
encephalitis. Neurol Sci. 2024;45(11):5429-5439.
Stefani A, Högl B. Sleep in Parkinson's disease: the role of OSA and RBD. Lancet Neurol. 2023;22(6):552-562.
Giannini G, et al. Early onset sleep disorders predict severity, progression and death in multiple system atrophy. J Neurol. 2025;272(3):239.
Castronovo V, et al. The effect of CPAP on cognition in OSA patients: a systematic review and meta-analysis. Sleep. 2024;47(2):zsad280.
Dalmases M, et al. Effect of CPAP on Neurocognitive Function in Patients with Mild Cognitive Impairment and Obstructive Sleep Apnea: A Randomized Clinical Trial. Am J Respir Crit Care Med. 2023;207(12):1597-1606.
Barnes KA. Delayed sleep-wake phase disorder. JAAPA. 2025;38(5):e7-e11.
Kim J, et al. ChatGPT vs. sleep disorder specialist responses to common sleep queries: Ratings by experts and laypeople. Sleep Health. 2024;10(6):665-670.
Ren J, et al. Longitudinal decline in DAT binding in Parkinson's disease: connections with sleep disturbances. BMC Med. 2024;22(1):550.
