In Farida Dakterzada, Nathalia Montero-Castilla, Anna Carnes-Vendrell and Gerard Piñol Ripoll’s narrative review, the authors explore how obstructive sleep apnoea might contribute to Alzheimer’s disease. Obstructive sleep apnoea is a condition where breathing repeatedly stops and starts during sleep, which has a high prevalence in patients with Alzheimer’s disease and is also considered a risk factor of the latter. The study focuses on the potential physical effects of obstructive sleep apnoea (low oxygen levels during sleep and constant waking up) on brain health and its links to the progression and development of Alzheimer’s disease.
Key findings suggest that the repeated drops in oxygen (intermittent hypoxia) and disrupted sleep (sleep fragmentation) caused by obstructive sleep apnoea lead to inflammation and damage of the blood vessels in the brain, leading to an acceleration in the buildup processes of harmful proteins i.e. amyloid-beta and tau; thus accelerating the clinical Alzheimer’s disease progression. The review highlights that intermittent hypoxia and sleep fragmentation are two of the most important players in this regard, working together and possibly leading to oxidative stress and inflammation in the brain. Consequently, connections between brain cells are damaged (cerebrovascular dysfunctionality). Moreover, poor sleep quality due to repeated sleep interruptions and lack of sleep impact memory consolidation and affect the glymphatic system which cleans out waste products in the brain.
The authors point out the need to learn more about whether treating sleep apnoea with a device which helps keep airways open during sleep can modify Alzheimer’s disease biomarkers and its effectiveness on the cognitive evolution of patients with Mild Cognitive Impairment and/or Alzheimer’s disease. It will also be of importance to know more about sex differences for developing treatment strategies.
https://link.springer.com/article/10.1007/s40675-025-00340-0
