Can Sleep Apnea Cause Alzheimer’s?

A few days ago, I ran across two studies about obstructive 

sleep apnea (OSA) and brain structure in my sleep medicine 

journals that had me wondering: Could there be a link 
between Alzheimer’s Disease (AD) and obstructive sleep 
apnea?  
 
The first study showed that people with OSA (see below) had 
a much higher incidence of silent lacunar infarcts on an 
MRI scan. Lacunar infarcts are very small areas of 
clotted small blood vessels in the brain. Essentially, 
these are microscopic strokes. 
 
The second article showed that people with OSA had 
multiple areas of brain tissue that received significantly 
lesser amounts of blood flow. If a small vessel in your 
brain doesn’t get very much blood flow, then there’s a 
higher chance of clotting as well. A natural consequence of 
this process is that you’ll get scarring and changes that 
can overlap with findings that are seen in AD. Also, if you 
get less blood flow in your brain region, then you’ll have 
less neurotransmitter production and less need for glucose. 
 
One of the hallmarks of (AD) is what’s found under the 
microscope during an autopsy. Two common findings of those 
with AD are neurofibrillary tangles (NFTs) and senile 
plaques (SPs). These are the scar tissue-like end-stage 
findings for many types of nerve damage. Although not 
specific to Alzheimer’s alone, NFTs and SPs are routinely 
stated as being one of the distinctive markers for this 
devastating condition. However, despite the millions or 
even possibly billions of dollars of research in this area, 
we still don’t know why this happens, what causes it or 
even how to prevent it. 
 
As I was reading through these two articles, in conjunction 
with all the latest research about AD, I couldn’t help but 
to see a distinct merger between OSA and AD. This, in turn 
made me think about a short satirical video by a renowned 
osteopath Dr. Joseph Mercola and then all I could think 
about were skid marks on the side of the road. 
 
 
The Skid Marks of Healthcare 
 
This 10 minute video describes a town called Allopath. Due 
to budget cuts and an absence of stop signs at one 
especially busy intersection, the town experiences an 
alarming number of traffic accidents and injuries. As a 
result, a consultant with the Motor Division (MD) is 
brought in to diagnose the problem, and after careful 
analysis, he proclaims that the reason for all the traffic 
accidents is due to the presence of tire skid marks and his 
solution?: Cover up the deadly skid marks with teflon. 
Bolstered by the facts of this MD’s research the 
townspeople rally together to rid the town from offending 
skid marks. In doing so, new industries begin to crop up in 
their town.  
From a Teflon factory to ambulances and hospitals to car 
repair shops repairing the cars damaged by the increase in 
traffic accidents, the town’s economy booms. Yet, as the 
town’s economy grows, the rate of traffic accidents, rather 
than going down, inversely gets worse as the slick Teflon 
only causes more accidents. Eventually, the town’s economy 
crashes as many of the townspeople become disabled. In 
short, this video reveals a sad but true account of what’s 
happening with our health care system today.  
 
Some of the cutting edge AD research in the prevention of 
worsening memory and cognitive functioning focuses on 
enhancing certain neurotransmitters and metabolic 
processes, such as acetylcholine or glucose. Drugs that 
lower enzymes or proteins that naturally degrade 
acetylcholine are shown to help with memory and cognition. 
Other research focuses on the biochemical and genetic 
properties of these NFTs and SPs, which are acknowledged to 
be the end-stage result of nerve damage and ultimate death. 
The reasoning is that by preventing NFTs and SP, we can 
prevent Alzheimer’s. 
 
In so far as these very complex studies go, however, none 
has yet to explain how and why all these factors for AD 
interrelate. Until you consider, however, the possibility 
that Alzheimer’s may be one of many symptomatic end stages 
of obstructive sleep apnea (OSA). 
 
 
OSA and AD: How Are they Alike? 
 
Research reveals that people at risk for AD are also at 
risk for the routine cardiovascular conditions like high 
blood pressure, diabetes, and heart disease. Some 
researchers have stated that AD is a disease of the small 
vessels in the brain. Similarly, if you have OSA, you are 
more likely to have all of these heart problems, along 
with a higher likelihood to have strokes, or be obese. 
Another interesting symptom to note is that OSA promotes 
the kind of inflammation and clotting not unlike the kind 
of small blood clotting and neurotransmitter degeneration 
that’s commonly associated with those with Alzheimer’s. 
 
With all these similarities between OSA and Alzheimer’s 
Disease, it’s not too far-fetched to consider them 
complimentary if not to see that one may be an aggravating 
factor for the other. There’s even evidence of a common 
gene linking AD with OSA.  
 
Yet, even with all these studies showing strong 
correlations between OSA and AD, 80-90% of people with OSA 
are still not diagnosed in this country, and if my 
hypothesis is right this number probably includes many 
patients who are “at risk” for Alzheimer’s (i.e. family 
history, evidence of memory loss etc.) In fact, if would 
be even more important to screen for OSA when you are much 
younger, before neurologic impairment, heart disease, or 
more importantly, before Alzheimer’s sets in. In all of 
these scenarios, the time and money required in screening 
these potential patients for OSA would be miniscule 
compared to the rewards of preventing Alzheimer’s for even 
a small proportion of this population. 
 
 
We Can Learn A Lot From a Dummy 
 
As Mercola’s cartoon video showed, much of what we believe 
about scientific research is grounded in the premise that 
if it’s not too complex, it can’t be scientific. Even in 
the case of Alzheimer’s research and studies of OSA, much 
of the research is focused on what you can do after the 
disease has already set in. It may be that prevention 
methods, like eating right, exercising and sleeping well, 
seem too simple of a cure for such a complex problem like 
AD.  
 
I don’t mean to offend all the good-intentioned doctors and 
researchers working on a “cure” for AD. Granted, 
eventually, there will be many drugs out there to slow the 
progression of AD, just like all the medications that we 
have for high blood pressure and heart disease. But could 
it be that by allowing these drugs to be so freely 
dispensed after the onset of disease, we’re providing a 
false sense of security for those “at risk” patients who 
may have otherwise put more effort into maintaing a 
healthier lifestyle? 
 
Similarly, by just covering up the tire skid marks, rather 
than installing stop signs at that dangerous intersection, 
the town of Allopath thought they could “cure” traffic 
accidents. Of course, neither are fail safe measures for 
traffic accidents. Although not as sophisticated as 
Teflon,however, stop signs would have at least forced the 
citizens of Allopath to become more responsible drivers. 
Teflon just made the problem spiral out of control. 
 
So the next time you hear screeching tires, stop to note 
the skid marks. Better yet, opt for prevention rather than 
easy cures. Moreover, if you have a history of AD in your 
family, and have noticed lately that you’re exhibiting 
signs of chronic fatigue or impaired memory or are 
experiencing classic symptoms of OSA, get a sleep study (to 
get a listing of sleep study centers in your area visit: ). 
Since AD is not (yet) currently reversible, it’s important 
to become proactive in preventing anything that can cause 
or aggravate it while you’re young to prevent any future 
brain injury.

Please note: I reserve the right to delete comments that are offensive or off-topic.

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5 thoughts on “Can Sleep Apnea Cause Alzheimer’s?

  1. Finally!!
    I have been asking the medical staff at all the facilities I’ve worked to what the connection between the Alzheimer’s and sleep apnea. I’ve noticed that my patients with AD would actually have 30sec or more periods of apnea.
    Please research this even further.

  2. Hi, good article… thx…
    i can’t find the link to the first report,
    do you have a copy of that one ??
    pls.. let me know…
    anton

  3. Hello, mr. Park,
    Thank you so much,.. for your fast reaction. I will study this one…
    Now i had time to watch your video too. Your talking about treatment of the soft palate…
    What do you think about daily 6/8 hours “mouth breathing” while sleeping? I thought its more healthy to breath through the nose? is not?
    thanks, Anton