By Dr.Manvir Bhatia, Ananya, 19/10/2023
Sleep is a very important part of our life. It is when our body relaxes, rejuvenates and repairs itself. It is vital for good physical and mental health. However, there are various factors that can impair good sleep. Sleep apnea is a major one. It is a condition in which there are repeated interruptions in breathing during sleep. This phenomenon can potentially affect the brain by dropping the blood oxygen levels thereby leading to a range of various other health complications.
There are various studies to show the adverse effects of sleep apnoea on brain health. According to a study published in the European Respiratory Journal by Alchanatis et al., obstructive sleep apnoea can lead to axonal loss or dysfunction. It also impairs metabolism of the myelin in the frontal periventricular matter. It also forms lesions in the neuronal circuits of the brain causing irreversible cognitive deficits in patients.
Here we have discussed a few possible points that establish a link between sleep apnoea and brain damage:
Oxygen Deprivation: The breathlessness that occurs during sleep in case of OSA is a result of hypoxia. This means that the blood oxygen level drops down and the brain does not receive enough oxygen. This leads to detrimental effects on the brain.
Structural Changes : Chronic Sleep Apnoea especially is very harmful for the brain and can cause structural changes. Studies have shown that people with untreated sleep apnea may have alterations in brain structures, including the hippocampus (involved in memory) and the prefrontal cortex (involved in executive function and decision-making).
Inflammation: OSA can trigger inflammation in the brain. This can contribute to various neurological disorders and cause cognitive decline.
Mood Disorders: Sleep apnea is also linked to mood disorders such as depression and anxiety. These mood disorders can, in turn, affect the overall brain functioning.
Disrupted Sleep Patterns: The repeated awakenings and disruptions in sleep caused by sleep apnea can lead to fragmented sleep. This fragmented sleep can prevent the brain from going through the normal sleep cycles, including the important REM (rapid eye movement) stage associated with memory consolidation and cognitive processing.
Owing to the above mentioned factors and many more, OSA makes an individual very susceptible to cognitive impairment, neurodegeneration and various neurological disorders such as dementia, stroke, etc. Patients often complain that they are finding it very difficult to concentrate, remember things properly and have decreased alertness. It also causes excessive daytime drowsiness which impairs the ability to think clearly and perform regular tasks.
Thus, it is very important to manage sleep apnoea. If it is at the initial stages, then making appropriate lifestyle changes helps control its progression. However, at the severe stages, medical intervention is a necessity. For the treatment of OSA, we have methods like
Continuous Positive Airway Pressure (CPAP) Therapy: In this, the patient has to wear a mask over the nose and mouth while sleeping. The machine delivers a continuous stream of air pressure, which helps keep the airway open and prevents apneas.
Bi-level Positive Airway Pressure (BiPAP) Therapy : This is also a form CPAP that is used for patients with a more severe OSA. It offers different pressure levels for inhaling and exhaling and is often used for individuals who find it difficult to tolerate constant air pressure.
Adaptive Servo-Ventilation (ASV) : It is used for treating complex or central sleep apnea. They adjust airway pressure on a breath-by-breath basis to maintain normal breathing patterns.
Oral appliances: These help reposition the jaw and tongue to keep the airway open. These devices are most suitable for mild to moderate OSA cases.
In addition to all of these, the following lifestyle changes contribute to the alleviation of sleep apnoea:
Maintain a regular sleep schedule and aim for 7-9 hours of quality sleep per night.
Create a comfortable sleep environment, including keeping the bedroom dark and quiet.
Avoid heavy meals and caffeine close to bedtime.
Excess weight, especially around the neck, can contribute to the narrowing of the airway, increasing the risk of obstructive sleep apnea (OSA). Losing weight through diet and exercise can improve or even eliminate sleep apnea symptoms in some cases.
Thus, we can conclude that sleep apnoea should never be taken lightly. It is very important to manage and treat it well depending upon its type and severity. It’s crucial to work closely with a healthcare provider, such as a sleep specialist and have regular check-ups and follow ups with them so as to monitor the effectiveness of your treatment and make necessary adjustments.
References:
Alchanatis, M., Deligiorgis, N., Zias, N., Amfilochiou, A., Gotsis, E., Karakatsani, A., & Papadimitriou, A. (2004). Frontal brain lobe impairment in obstructive sleep apnoea: a proton MR spectroscopy study. European Respiratory Journal, 24(6), 980-986.
