Dr Chitra Lal: OSA Might Be a Modifiable Risk Factor for Alzheimer Disease

Chitra Lal, MD, D-ABSM, FCCP, FAASM, FACP, ATSF, professor of medicine at Medical University of South Carolina, talks about how there might be a link between obstructive sleep apnea (OSA) and Alzheimer disease (AD), and that treating sleep apnea early and aggressively may help prevent AD development.

Alzheimer disease, obstructive sleep apnea (OSA), and mild cognitive impairment (MCI) likely have a bidirectional relationship, emphasizing the need for early and aggressive treatment of OSA, said Chitra Lal, MD, D-ABSM, FCCP, FAASM, FACP, ATSF, professor of medicine at Medical University of South Carolina.

Lal presented findings on Sunday at the at the 2023 American Thoracic Society International Conference, with simultaneous publication in Annals of the American Thoracic Society.


What is the relationship between OSA, Alzheimer disease, and MCI?

The relationship between obstructive sleep apnea, mild cognitive impairment, and Alzheimer disease is likely bidirectional. It's a complex bidirectional causal relationship, but currently we don't have enough data to prove that. Having said that, obstructive sleep apnea has been associated with mild cognitive impairment; about 1 out of 4 OSA patients will have some degree of cognitive deficits.

OSA is also very common in Alzheimer disease, and we know that mild cognitive impairment progresses to Alzheimer disease at the rate of about 10 to 15 persons per year. So, it's very possible that obstructive sleep apnea is a modifiable risk factor for Alzheimer disease, and treating OSA early and aggressively might prevent the development of Alzheimer disease as a downstream effect.

Alzheimer disease in itself can possibly also worsen sleep apnea because it impacts breathing through complex neurological mechanisms. But again, we don't have enough data to support a bidirectional causal relationship but there's strong biological plausibility that it is a bidirectional relationship.

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