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How is Sleep Apnea Affecting Your Brain?

by on March 28, 2017 | Posted in Sleep Apnea

Obstructive sleep apnea (OSA) not only has a large effect on the heart but can also alter and cause severe effects to the brain. These changes in brain matter can damage to neurons that can lead to memory loss, Alzheimer’s disease and other complications. In recent studies, it is shown that those with sleep apnea have changes of neurotransmitters in the brain.

People with sleep apnea tend to experience symptoms that include excessive daytime fatigue, shortened attention span, moodiness, shortened response time and reduced short-term recall. These are just a small range of daytime symptoms caused by lack of sleep and waking up multiple times throughout the entire night. Studies have shown that people with sleep apnea have trouble converting short-term memories into long-term ones. This memory-creating process occurs during sleep, and if you don’t sleep it leads to impaired memory formation and forgetfulness.

Sleep apnea may hasten memory and cognitive thinking declines, leading to earlier diagnoses of mild cognitive impairment and Alzheimer’s disease. On an average people with OSA were diagnosed with mild cognitive impairment (MCI) nearly 10 years earlier than those who are healthy according to New York University researchers.

Patients with Alzheimers Disease have a five times higher chance of presenting with OSA than cognitively non-impaired individuals of similar age. In addition, data also suggests that around half of patients with Alzheimers Disease have experienced OSA at some point after their initial diagnosis. The changes in cerebral blood flow and the cellular redox status in OSA patients contribute to cognitive decline and may further aggravate Alzheimer’s progression.

“This study is adding to the emerging story that sleep apnea may be contributing in some way to the acceleration of cognitive decline as you age,” said study coauthor. Dr. Andrew Varga, an instructor in medicine at the New York University Sleep Disorders Center. “And that is potentially another good reason to get evaluated and treated.”

Sleep Apnea can actually change the size of the brain. Duress caused during an apnea ( which starves the brain of oxygen) paired with chronic fatigue, can cause physical, & measurable brain damage. Researchers at UCLA compared the mammillary bodies, structures in the brain that are responsible for memory storage of several adults suffering from sleep apnea with those of healthy people. It was concluded that the mamillary bodies in the people with the sleep disorder were nearly 20% smaller.

Doctor Seung Bong Hong of the Sungkyunkwan University School of Medicine in Seoul to concluded that “Poor sleep quality and progressive brain damage induced by OSA could be responsible for poor memory, emotional problems, decreased cognitive functioning and increased cardiovascular disturbances.” In 2008, a UCLA study found significant damage in the brain’s fiber pathways and structural changes in its white matter. These are areas that regulate mood, memory, and blood pressure.

A February 2016 study published in the Journal of Sleep Research by the UCLA School of Nursing investigated the injury caused to the insular cortex of the brain by sleep apnea. It focused on the levels of two important brain chemicals, called neurotransmitters: glutamate and gamma-aminobutyric acid, known as GABA. “We actually found substantial differences in these two chemicals that influence how the brain is working,” said Paul Macey, the lead researcher on the study and an associate professor at the UCLA School of Nursing. “It is rare to have this size of the difference in biological measures,” Macey said. “We expected an increase in the glutamate because it is a chemical that causes damage in high doses and we have already seen brain damage from sleep apnea. What we were surprised to see was the drop in GABA. That made us realize that there must be a reorganization of how the brain is working.” Macey results were encouraging. “In contrast with damage, if something is working differently, we can potentially fix it.” “Stress, concentration, memory loss — these are the things people want fixed.”

There is evidence that treating sleep apnea, (with an Oral Appliance or in this particular study with CPAP therapy) can possibly return a patients’ brain chemicals back to its normal levels. According to the American Academy of Sleep Medicine, studies evaluated the effects of therapy on several subjects who had significant damage of their brain matter. However, after a year of treatment, the patients’ white matter was almost completely restored, while their gray matter had a faster recovery time of only three months. The results of several studies suggest that the early treatment of OSA, particularly in the early stages of Azlhermiers and dementia, may decelerate dementia progression (Ancoli-Israel et al., 2008; Cooke et al., 2009b; Troussière et al., 2014).

If you have symptoms of Sleep Apnea, talk to your us and find out more about testing for sleep apnea. Raphaelson Dental Sleep Center offers a home sleep study that can help diagnose your symptoms. If you’re ready to schedule a sleep study contact us now.

References:

Ancoli-Israel S., Coy T. (1994). Are breathing disturbances in elderly equivalent to sleep apnea syndrome? Sleep 17, 77–83. [PubMed]

Ancoli-Israel S., Klauber M. R., Butters N., Parker L., Kripke D. F. (1991). Dementia in institutionalized elderly: relation to sleep apnea. J. Am. Geriatr. Soc. 39, 258–263. 10.1111/j.1532-5415.1991.tb01647.x [PubMed] [Cross Ref]

Ancoli-Israel S., Palmer B. W., Cooke J. R., Corey-Bloom J., Fiorentino L., Natarajan L., et al. . (2008). Cognitive effects of treating obstructive sleep apnea in Alzheimer’s disease: a randomized controlled study. J. Am. Geriatr. Soc. 56, 2076–2081. 10.1111/j.1532-5415.2008.01934.x [PMC free article] [PubMed] [Cross Ref]

Cooke J. R., Ancoli-Israel S., Liu L., Loredo J. S., Natarajan L., Palmer B. S., et al. . (2009a). Continuous positive airway pressure deepens sleep in patients with Alzheimer’s disease and obstructive sleep apnea. Sleep Med. 10, 1101–1106. 10.1016/j.sleep.2008.12.016

Troussière A. C., Charley C. M., Salleron J., Richard F., Delbeuck X., Derambure P., et al. . (2014). Treatment of sleep apnoea syndrome decreases cognitive decline in patients with Alzheimer’s disease. J. Neurol. Neurosurg. Psychiatr. 85, 1405–1408. 10.1136/jnnp-2013-307544 [PubMed] [Cross Ref]

American Academy of Sleep Medicine
Macey, P. M., Sarma, M. K., Nagarajan, R., Aysola, R., Siegel, J. M., Harper, R. M. and Thomas, M. A. (2016),

Obstructive sleep apnea is associated with low GABA and high glutamate in the insular cortex.
Journal of
Sleep Research. doi: 10.1111/jsr.12392
http://news.health.com/2008/06/11/sleep-apnea-damage-brain-memory/

>Science Daily
>https://www.uclahealth.org/news/sleep-apnea-takes-a-toll-on-brain-function

University of California – Los Angeles. “Memory Loss Linked To Common Sleep Disorder.” ScienceDaily. ScienceDaily, 13 June 2008.
WebMD

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Oral cancer, heart disease, stroke, lung diseases like chronic bronchitis and emphysema, osteoporosis, cataracts, and now you can add Obstructive Sleep Apnea to that list. Smoking is the leading cause of many medical conditions that can easily be prevented. There have been various studies now linking smoking to Obstructive Sleep Apnea. Those who smoke are three times more likely of developing OSA. About 35% of smokers have OSA.

Obstructive Sleep Apnea occurs when the muscles of the throat or relax and cause an obstruction of the airway. This can be the result of excessive fatty tissue, an oversized tongue or uvula, a soft palate or a narrow airway.  It can also is caused by anatomical swelling in the airway that happens when you smoke. OSA stops your breathing for periods of time and lowers your blood oxygen saturation because of the lack of oxygen.

These disruptions in breathing and lack of oxygen cause sleep fragmentation.  Sleep fragmentation during OSA “breaks up your sleep”, as you are temporarily woken up to resume breathing in a Flight or Fight response. The person’s mind and body have not restored during the night making them fatigued during the day, creating morning headaches or problems concentrating. Not to mention there are many serious medical consequences that result from a lack of sleep and a lack of oxygen in the body.

A study at Johns Hopkins University found 22.5 percent of smokers said they experienced restless sleep, in comparison to 5% of nonsmokers. Another study proves that smokers spend more time during the night in the lighter sleep stages, never reaching REM stage while non-smokers experienced more restorative, deep sleep.  Heavy smokers with OSA had a higher percentage of light sleep in NREM stages N1 and N2 and a lower percentage of deep sleep found in NREM stage N3, because of sleep fragmentation caused by OSA.

Smoking causes induced upper airway inflammation caused by nicotine irritation of the upper airway muscles. It inflames the nose, uvula, and throat, which obstructs and reduces the space in the airway. Long-term smokers with moderate and severe OSA, have increased uvular mucosa and uvular collapse. An inflamed uvula is also known as “battered uvula.”  This can be attributed to the thickened mucosa caused from smoking and a response to nicotine withdrawal during sleep. During the first hour of sleep, nicotine acts as a stimulant, reducing the number of apneas and hypopneas during sleep.  According to the National Sleep Foundation, the stimulating effects of nicotine can cause smokers to develop insomnia if they smoke frequently and close to bedtime. (As we have mentioned in the past OSA is commonly misdiagnosed as insomnia and its primary symptoms.) As nicotine withdrawal continues throughout the night, your sleep apnea increases due to a rebound effect produced by the withdrawal.

Smoking is a known risk for snoring, and snoring is a symptom of OSA. A study found a higher association between heavy smokers and a higher AHI of greater than 50 events per hour (severe apnea is 30 events per hour). Smokers were also found to have longer durations of hypoxia with significantly lower oxygen levels.

If you have sleep apnea and you smoke, please talk to one of our dental professionals. Help is available to you at Raphaelson Dental Sleep Center. Our professionals are here to help to improve your health and quality of life.

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Far too many Americans see sleep as a luxury rather than a necessity. Many of us work long hours and overbook our schedules with other activities, getting an average of 6 hours of sleep. Sleep mental and physical recharge is important for your health. However when it is time to catch some zzzs’ many people have a hard time falling asleep. Below are some natural remedies, herbs, and tips that promote a better night sleep.

The science of sleep…

When you consume tryptophan, it is converted to 5-HTP, which then turns into serotonin. The serotonin then converts to melatonin, which makes you sleepy and tells you is time to go to bed. More melatonin is produced at night, while the amount lessens with more light or in the morning. Melatonin also controls your body temperature, working with the central nervous system to sync our biological clock.

Let’s get started…

1. Cherries or Cherry Juice

Cherries are rich in tryptophan, an essential amino acid.  Tryptophan converts to serotonin which then turns into melatonin.

2. Valerian Root

Valerian root is a natural sedative and sleep aid. It increases the amount of GABA (gamma-aminobutyric acid) which aids in regulating your nerve cells and has a calming effect. It is also used as a natural anxiety remedy because of these calming properties. You should be aware that Valerian Root might be a little smelly.

3. Electronics

Your bedroom is not a place to watch T.V. It’s also not intended to be your second office,  it should be a place to rest. Electronics not only keep you awake and they carry stress into your room. So it’s probably best to get any form of a screen out of sight, it is clinically proven to disrupt your sleep.

4. Schedule A Routine

We are creatures of habit. Establishing a routine every night will help with an easier to transition from being awake to going to sleep. Some ideas before bedtime can include drinking a cup of warm tea or milk, taking a warm bath (consider adding some lavender into your bath for aromatherapy), or reading a chapter in your favorite book.

5. Melatonin

This can be taken in a capsule form, however many foods carry melatonin such as Cherries (like we mentioned earlier Tryptophan is converted to melatonin) and Bananas. Bananas contain tryptophan, and potassium & magnesium as well, which are also muscle relaxants.

6. Exercise

Not only will you sleep better, but you’ll have more energy throughout your day. Set up a daily routine, even if it is just walking 30 minutes a day.

7. Chamomile

Chamomile helps relax your muscles. There is a theory that a substance called apigenin can bind to GABA receptors which affect the central nervous system and sleepiness. If possible, try to use fresh flower Chamomile for your tea. You can add a little bit of honey or lemon for taste as well.

8. Aromatherapy

In a study that followed brain activity with an EEG machine, subjects that were exposed to the scent of lavender experienced better moods and their brainwaves suggested that Lavender does increase drowsiness.

9. Magnesium

Most people have a magnesium deficiency, primarily due to their poor diet. Magnesium is vital to the function of GABA receptors, which is the main neurotransmitter that calms your central nervous system and prepares you for sleep. The best way to boost up magnesium is to eat a balanced diet, however taking supplements will also help.

10 . Saint John’s Wort

Saint John’s Wort is used frequently used to help with depression but it can also aid with disrupted sleep. Its main constituent-hypericin raises the overall level of serotonin in the brain. More serotonin creates more melatonin in your system.

11. Catnip

Catnip has a sedative effect on humans. The compound responsible for this is called nepetalactone. While it can make cats wild and hyper, it has an opposite effect on humans making you relaxed, drowsy, and ready for bed. Enjoy it in the form of a warm tea before bed with a little bit of honey.

These tips are not intended to replace seeking medical attention for a sleep disorder. If you have problems falling or staying asleep for a prolong period of time you should talk to one of our dental professionals or your primary care provider about your symptoms. As we have mentioned in a previous blog insomnia and sleep apnea are linked and if let untreated can lead to serious medical consequences.  Raphaelson Dental Sleep Center offers a home sleep study that can help diagnose your symptoms. It is important to seek to root cause of your sleep problem. Insomnia is one of the primary symptoms of OSA, and can only be treated with an oral appliance, CPAP or corrective surgery. Also, you should always consult with your primary physician before taking any of the herbs mentioned above. 

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