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
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.
Snoring can be a sign of a medical condition not only damaging to you health, but also to your relationship with your bed partner. All kidding aside snoring is no laughing matter (although your bed partner is probably is not thrilled about it). Snoring can be sign that your airway is not open and there can be a possible obstruction. Some snorers spend most of the night gasping for air due to a condition called Sleep Apnea. Sleep Apnea causes pauses in your breath interrupting your sleep and decreasing your blood oxygen levels. These sudden drops in blood oxygen levels during sleep apnea episodes increases your blood pressure and overworks the cardiovascular system and other major organs. If you have obstructive sleep apnea you have a higher risk of developing High Blood Pressure. Obstructive sleep apnea will also increase your risk of Heart Attack, Abnormal Heartbeats, and Stroke. If you already suffer from any Heart disease, you should be aware that multiple episodes of low blood oxygen (hypoxia or hypoxemia) can lead to sudden death from an irregular heartbeat. Most people who have sleep apnea don’t know they have it, a family member or bed partner will often be first to notice signs and will ask their sleep partner to seek treatment. Many snorers at this point will either call their doctor for a referral to a Sleep Dentist that can make them a custom oral appliance or hope they find some sort of “DIY boil and bite” online or at a local drug store.
The American Academy of Sleep Medicine (AASM) has approved oral appliance therapy (OAT) as a first line treatment for patients diagnosed with Obstructive Sleep Apnea. Cheap, over-the-counter appliances are clinically unproven and can be potentially dangerous. Just because they are inexpensive and convenient does not mean you should try them! Do you remember the saying ” You get what you pay for?” Most of these oral appliances are not FDA approved for Sleep Apnea despite their claims of being effective and proven to help. When these boil and bites are not fitted properly, (which is often the case since most people are not dental professionals that have experience taking proper impressions of teeth) these over-the-counter appliances can cause unwanted side effects, such as jaw problems, tooth movement or can even have an adverse effect- worsening your sleep apnea. At the Raphaelson Dental Sleep Center, we use the best materials and labs to create a custom, comfortable, and durable oral appliance with a precise fit. Also, we follow up on all oral appliance treatment with a diagnostic sleep study ensuring that the oral appliance fits and functions properly, treating Sleep Apnea. Another issue with these “do it your self oral appliances” according to Dr. Alan Lowe, professor of orthodontics at the University of British Columbia in Vancouver, is that they mask a relief in snoring without addressing the apnea. Many people often overlook what is called “silent apnea” that could still threaten their health or even lead to death.
So here is The Bottom Line- People with Sleep Apnea need to seek professional help from a doctor or a dental sleep specialist. If an oral appliance is an option for you, it should be fitted by a dentist specially trained in Dental Sleep Medicine. All of our dental sleep specialists at the Raphaelson Dental Sleep Center are qualified and trained in Dental Sleep Medicine, offering our patients optimal care in diagnosing and treating Sleep Apnea. If you believe you have Sleep Apnea please call our office for a complimentary Airway Evaluation. Most major medical insurances are accepted and offer benefits for Oral Appliance Therapy. Let us help you “Transform your sleep, and Redefine your Health”
