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Vascular Dementia And Sleep Apnea

What Sleep Problems Can Be Caused By Dementia What Sleep Problems Can Be Caused By Dementia

Sleep Problems with Dementia

Insomnia Insomnia.

Insomnia includes a wide range of sleep problems, such as taking a long time to fall asleep, waking up often during the night, having nightmares and waking up early in the morning. These result in the person not getting enough good-quality sleep.

Insomnia is a common problem for people with dementia, and different causes include the following:

  • The person may be struggling with pain or discomfort.
  • They may have other health conditions that make sleep more difficult, such as heart or breathing problems, heartburn, constipation, urinary tract infections or incontinence.
  • They may be feeling anxious, stressed or depressed.
  • They may be taking medications that cause insomnia as a side effect. This is common with drugs prescribed to improve dementia symptoms, such as donepezil, rivastigmine, or galantamine.

These drugs can also lead to very vivid dreams or nightmares. If this happens, they may find taking their medication in the morning rather than at bedtime helps.

There are drugs that can help a person get to sleep more easily. However, most have unpleasant or potentially dangerous side effects, such as dizziness and an increased risk of falls. This makes them less safe for a person with dementia to take. They tend to only be prescribed for very short-term use when the person has severe sleep problems.

Excessive daytime sleepiness Excessive daytime sleepiness.

For more information on hallucinations and delusions see Changes in perception.

Untreated Sleep Apnea May Increase Dementia Risk

Healthline There is a lot of evidence that links sleep apnea to Alzheimers disease risk, added Bryce Mander, Ph.D, assistant professor, Psychiatry & Human Behavior, School of Medicine at the University of California, Irvine. But there is limited data on the beneficial effects of sleep apnea treatment on risk for dementia. He continued: This study offers proof of concept evidence that treating sleep apnea may reduce Alzheimers disease risk. also offers potential novel molecular targets for future study for those where positive airway pressure treatment is not feasible. Read more here >

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  • Treating Sleep Apnea May Reduce Dementia Risk

    People with obstructive sleep apnea who treat their apnea with the commonly-prescribed positive airway pressure therapy were less likely to be diagnosed with dementia.

    A new study finds older adults who received positive airway pressure therapy prescribed for obstructive sleep apnea may be less likely to develop Alzheimers disease and other kinds of dementia.

    Researchers from Michigan Medicines Sleep Disorders Centers analyzed Medicare claims of more than 50,000 Medicare beneficiaries ages 65 and older who had been diagnosed with OSA. In this nationally representative study, they examined if those people who used positive airway pressure therapy were less likely to receive a new diagnosis of dementia or mild cognitive impairment over the next 3 years, compared to people who did not use positive airway pressure.

    We found a significant association between positive airway pressure use and lower risk of Alzheimers and other types of dementia over three years, suggesting that positive airway pressure may be protective against dementia risk in people with OSA, says lead author Galit Levi Dunietz, Ph.D., M.P.H., an assistant professor of neurology and a sleep epidemiologist.

    Obstructive sleep apnea is a condition in which the upper airway collapses repeatedly throughout the night, preventing normal breathing during sleep. OSA is associated with a variety of other neurological and cardiovascular conditions, and many older adults are at high risk for OSA.

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    What Causes Sleep Apnea

    • Hereditary traits including a round head, thick neck, and narrow throat
    • Hyperthyroidism
    • Waking up from sleep severally to go to the bathroom

    However, the only way to conclusively diagnose the condition is through a physical examination.

    A physician will access an individuals complete medical history to figure out whether they have struggled with symptoms like snoring or daytime sleepiness for a considerable period.

    The doctor also EXAMINES the persons neck and head looking for the presence of any physical factors associated with the condition.

    The process often involves filling a questionnaire to establish a persons sleep patterns, the quality of sleep they get, and if they struggle with daytime drowsiness.

    Tests like polysomnograms, EEG, Pulse Oximetry, EKG, and Arterial Blood Gas may also be used to diagnose sleep apnea.

    Summary Of Promising Fluid Biomarkers Of Dementia That Could Be Used In Osa

    95 best Alzheimer

    OSA is increasingly recognized as a prevalent risk factor for dementia. What makes OSA particularly appealing in the context of preventive dementia strategies is that it can be treated efficiently with CPAP or other interventions. Whether screening and treating OSA could have an impact on the incidence of dementia remains to be investigated. To achieve this goal, epidemiological and mechanistic evidence needs to be drawn from intensive research efforts to properly establish OSA as a modifiable risk factor. Establishing a panel of promising biomarkers linking OSA to dementia has the potential to significantly advance our understanding of the pathophysiological mechanisms involved in neurodegeneration. Moreover, studying large cohorts of older adults with OSA using those biomarkers could also help developing protocols to identify OSA individuals who are at risk of dementia.

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    Association Between Sleep Apnea And Dementia

    Sleep is an important function for restoration of synaptic function and memory consolidation and integration. A prospective study conducted in mice found that the axon-spine interface size decreased by approximately 18% during sleep, indicating renormalization of synaptic strength and thus consolidation and integration of neural input. This was more evident in small and medium synapses than in large synapses. These changes usually occur during slow wave sleep, which may be less in patients with dementia due to more frequent awakenings . Another study demonstrated that patients with multi-domain MCI experienced decreased sleep dependent memory consolidation when compared to controls and patients with single domain MCI. Patients with MCI had more frequent oxygen desaturation and less stage N2 sleep when compared to the control group .

    Link Between Sleep Apnea And Increased Risk Of Dementia

    Date:
    Monash University
    Summary:
    A new study by Monash University has found that obstructive sleep apnea has been linked to an increased risk of dementia.

    A new study by Monash University has found that obstructive sleep apnea has been linked to an increased risk of dementia.

    The study, published in the Journal of Alzheimer’s Disease, and led by Dr Melinda Jackson from the Turner Institute for Brain and Mental Health, found that severe OSA is linked to an increase in a protein, called beta-amyloid, that builds up on the walls of the arteries in the brain and increases the risk of dementia.

    The study involved 34 individuals with recently diagnosed untreated OSA and 12 individuals who were asymptomatic for sleep disorders. It explored associations between brain amyloid burden using a PET brain scan, and measures of sleep, demographics and mood.

    The OSA group recorded a higher amyloid burden, poorer sleep efficiency and less time spent in stage N3 sleep .

    OSA is a common sleep disorder, affecting about 1 billion people worldwide and is caused by the collapse of the airway during sleep, resulting in intermittent dips in oxygen levels and arousals from sleep.

    “The significance of finding the association between increased brain amyloid in patients with OSA will allow for further research to explore in more detail the implications of treating OSA for reducing dementia risk,” Dr Jackson said.

    Story Source:

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    Preclinical And Prodromal Alzheimers Disease

    The preclinical stage corresponds to cognitively normal individuals who will later develop Alzheimers disease while the prodromal stage corresponds to individuals with mild cognitive impairment who will later develop Alzheimers disease. These stages can be identified longitudinally and may also be of interest in other type of dementias. Moreover, recent recommendations suggest that identifying preclinical and prodromal Alzheimers disease is possible at a single time point when abnormal biomarkers levels that are highly suggestive of Alzheimers disease pathology are present.

    Obstructive Sleep Apnea And Dementia Risk

    Sleep Issues and Dementia

    Obstructive sleep apnea is a chronic disorder caused by partial or complete occlusion of the upper airway during sleep. The insufficient airflow seen in obstructive sleep apnea leads to hypoxemia and sleep fragmentation. Obstructive sleep apnea affects approximately 12% of the US population, and is highly prevalent in minorities . For example, our published data from the Hispanic Community Health Study/Study of Latinos , the largest study of US Latino adults , showed an obstructive sleep apnea prevalence of 34% of males and 18% of females in age-, sex-, and obesity-adjusted models.1 Obstructive sleep apnea is diagnosed with the apnea-hypopnea index , an index of severity that combines pauses and partial obstructions in breathing.1,2 A patient with obstructive sleep apnea has an AHI â¥5 events per hour of sleep, while those with moderate-to-severe obstructive sleep apnea have an AHI > 15. Of importance, meta-analyses link obstructive sleep apnea to increased Alzheimerâs disease and related dementias.3 In HCHS/SOL, participants with obstructive sleep apnea had worse memory, language, and executive function, especially middle-aged females.4,5 Obstructive sleep apnea also increases the risk of hypertension, cardiovascular disease, and stroke, known contributors to dementia risk. In HCHS/SOL, hypertension was also associated with worse neurocognitive function and an increased prevalence of obstructive sleep apnea .6-8

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    Is There A Link Between Sleep Apnea And Dementia

    Researchers in Australia recently performed a study on sleep apnea and dementia that involved older adults. These individuals had all recently visited their doctors concerning issues with memory or mood, but did not have a previous sleep apnea diagnosis. During the study, researchers performed tests to assess the participants memory skills. Each participant was given an MRI scan that measured different parts of their brains. Then, the participants attended a sleep clinic where they were monitored overnight to look for signs of sleep apnea. The test measured brain activity and measured oxygen levels in the blood throughout the night.

    What researchers learned was that the patients who had signs of Obstructive Sleep Apnea also had signs that pointed toward dementia. These signs included changes in the brain in areas that affect mood, memory formation, recall, and other areas.

    Initial Causes Sleep Apnea And Vascular Dementia

    There are several different causes of memory loss. Some cause this condition in the young, while others may be more gradual. If you notice that your memory is weakening, its important to consult a medical professional. Whether the cause is mental illness, age, or a combination of factors, its important to seek treatment as soon as possible. People with extensive memory loss may have social difficulties and anxiety, which can lead to depression. They may be afraid they are letting their loved ones down, which can lead to anxiety and depression. Sleep Apnea and Vascular Dementia

    Fortunately, there are many causes of memory loss, and many of them are treatable. However, if you are experiencing serious memory problems, you may need medical treatment. If you have been undergoing any type of medication, you should consult with your doctor. Some people have other underlying conditions that may be causing their loss of memory. Alcohol abuse, sleep deprivation, or other mental health conditions can cause memory problems. You should seek out a medical professional if you suspect youre suffering from any of these conditions.

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    What Is Vascular Dementia

    Dementia refers to a disorder characterized by the chronic and progressive impairment of memory, loss of reasoning, and personality changes that result from various causes. One of the potential causes of this perceived memory loss is the accumulation of numerous small strokes within the brain. A stroke is the sudden loss of blood flow to an area of the brain that may lead to symptoms of weakness, numbness, vision loss, and speech difficulty. Strokes may also impact cognitive function, affecting language, memory, and organization. Dementia may occur in about 25 to 33% of people following a stroke.

    Vascular dementia is characterized by a subtle and progressive worsening of memory that occurs in a stepwise fashion due to strokes occurring within the brain. Deficits may begin suddenly and then remain stable during a plateau period before more insults to the brain occur. It can be difficult to distinguish from Alzheimers disease clinically, which occurs five times as often and is due to a different disease process. The conditions may overlap in some people.

    Risk factors for vascular dementia are the same as those for stroke. These include:

    Dementia Genetics Factors In Osa

    Common Sleep Problem Linked With Memory Loss

    Multiple genes were associated with the presence of OSA and its severity . However, very few of them have been linked to incident dementia. Looking at genes related to dementia risk, recent meta-analyses concluded that there is no association between APOE polymorphism and the presence of OSA . However, the APOE4 allele may interact with OSA to worsen cognitive performance: OSA severity was associated with worse memory, attention, executive functioning as well as worse global cognition only in APOE4 carriers . Polymorphisms of TNF- and interleukin-6 , which code for inflammatory cytokines, as well as HLA-DRB1 have all been associated with the presence of OSA , although how inflammation may lead to OSA remains to be clarified.

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    How Can I Help Manage A Loved Ones Sleep Patterns As Dementia Progresses

    Even though increased sleep is considered a normal side effect in dementia patients, trouble sleeping and excessive sleep have been tied to troublesome issues like depression, anxiety, and apathy.

    If your parent is in memory care or an assisted living facility, check in with the staff to ask if they have any sleep hygiene measures in place. Almost 75% of nursing home residents suffer from sleep disorders, likely caused by ongoing activities and health care procedures taking place all hours of the day. Options like dimming lights at night, providing sound machines in bedrooms, and limiting caffeine or other stimulants in the evenings can help communities promote good sleeping routines.

    When caring for a loved one at home, you can make environmental changes that might improve sleep.

    If youre worried that your parent is sleeping too much and suspect something other than dementia may be to blame, contact their doctor as soon as you can. Its possible that something else may be causing their extreme sleepiness, like a respiratory or cardiac issue or a negative response to a medication. Some causes of disruptive sleep patterns can be treated easily if theyre caught in time.

    What Is Sleep Apnea

    Sleep apnea, which means failure to breathe during sleep, can be obstructive or non-obstructive. Non-obstructive or central apnea occurs when the brain fails to signal the breathing muscles that its time to get active. In obstructive apnea, breathing fails because of a relaxed airway that fails to open up despite the brains insistence. Eventually, sometimes after more than a minute without breathing, the brain sounds its alarms urgently enough to jolt the muscles of breathing back into action. Sometimes this wakes the sleeper, but more often the periods of apnea and gasping serve only to rob sleep of its restful and restorative quality. A respiratory infection or excessive alcohol use can also interfere with breathing during sleep. Chronic and severe apnea, however, is a prolonged, debilitating condition.

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    Symptoms Of Vascular Dementia

    Like other forms of dementia, symptoms can vary depending on what area of the brain has been affected. Whats more, these signs often overlap with other dementia conditions, like Alzheimers disease.

    It can be difficult to differentiate vascular dementia from other similar cognitive disorders, but hallmarks of this disease tend to involve speed of thinking and problem solving, rather than severe memory loss.

    Also, these symptoms can come on suddenly like right after a stroke event so the link to the stroke can be clear, whereas cognitive decline with Alzheimers disease is much more gradual.

    Can Sleep Apnea Affect Your Memory

    The importance of vascular disease in the management of dementia

    When you have sleep apnea, it is not uncommon to wake up in the morning feeling fatigued, even when you have gotten a full nights sleep. Other sleep apnea symptoms can include depression, irritability, headaches, and mood swings, none of which are good for your mental acuity.

    Effects of untreated sleep apnea over time can include serious cognitive impairment. In many people, sleep apnea can lead to insomnia and sleep deprivation. According to studies, being awake for 20 consecutive hours or more affects the brain as much as having a 0.10 blood alcohol content. Poor sleep quality can also cause issues with cognitive function, including the ability to form new memories. In the sleep apnea study, researchers found that people who had low levels of oxygen in their blood had reduced thickness in the temporal lobes of their brain. These regions are important in memory. People who have dementia also have reduced thickness in these areas.

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    Conflict Of Interest Statement

    MM is the principal investigator on a research grant funded by ResMed Foundation evaluating the effects of adaptive servoventilation treatment of central apnea syndromes on healthcare utilization that is not relevant to the current work. MM is the recipient of the Paul and Ruby Tsai and Family Fund Career Development Award at Mayo Clinic. VS is a Consultant for Respicardia, ResMed, U-Health, GlaxoSmithKline, Roche and Bayer. He is an investigator on the SERVE-HF Steering Committee and is working with Mayo Health Solutions and their industry partners on intellectual property related to sleep and cardiovascular disease. The Philips Respironics Foundation has provided a gift to Mayo Foundation. The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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