5 Areas of Brain Damage Caused By Obstructive Sleep Apnea

Screen Shot 2014-10-16 at 10.06.59 PMOne of the most common complaints by my patients with obstructive sleep apnea (OSA) is memory loss. Judith is a 55 year old woman who used to have a sharp memory, but now is having trouble with names and losing her keys all the time. Things got much worse when she gained more weight, which worsened her snoring. She was eventually placed on CPAP for her moderate obstructive sleep apnea, and is now happy to report that while her memory is not back to normal, it is much improved.

At a recent Airway Dentistry conference I went to last month, the most memorable topic was given by Dr. Ronald Harper, Distinguished Professor of Neurobiology at the David Geffen School of Medicine at UCLA. I’ve been following his work over many years, but his presentation only confirmed my suspicion that there can be significant brain damage with untreated obstructive sleep apnea. Based on various high-tech MRI technology, specific known areas of the brain can be damaged with repeated episodes of apneas and low oxygen levels. Note that the word “damage” can mean low functioning, or dead brain cells. Here are 5 particular areas of brain damage from untreated obstructive sleep apnea with their specific symptoms:

1. The right insular cortex. This is the area of the brain that regulates sympathetic control of the autonomic nervous system. If the insular cortex is damaged, baroreflex control is affected. The insula also controls nerve endings that relate to pain. Both OSA and sleep apnea patients are found to have insular cortex injury.

2. The vetrolateral medulla (VLM). This area of the brain controls breathing and blood pressure regulation. Injury to this area blunts and delays heart rate responses to sudden pressure changes. One sided VLM injury leads to an asymmetric response to blood pressure challenge, which can potentially cause heart rhythm problems.

3. The cerebellum is the area of the brain that helps adjust blood pressure control and motor coordination, including breathing. Damage to this area prevents the ability to coordinate vascular and motor activity.

4. The hippocampus is found to be significantly smaller in people with obstructive sleep apnea. This area of the brain processes short and long-term memory and spatial navigation. One study found that hippocampal damage can be partially reversed after a period of CPAP. The hippocampus is also one of the first areas to be damaged in Alzheimer’s disease.

5. Mammary bodies are important for memory recall, as well as for memory for certain smells. These structures are much smaller in patients with OSA, and almost nonexistent in patients with heart failure. The hippocampus and mammary bodies are also found to be damaged in chronic alcoholism.

If OSA can damage critical areas of the brain that regulates breathing, balance, memory, and the autonomic nervous system, the implications are enormous. For example, heart failure is thought to lead to central sleep apnea. Is it possible that untreated obstructive sleep apnea can damage breathing and reflex centers in the brain that can lead to heart failure? What proportion of Alzheimer’s disease is actually undiagnosed OSA? The possibilities are endless. As they say at the end of every scientific journal article, more studies are needed.

If you have both OSA and memory problems, did your memory improve at all after being treated? Please tell your story below.

(Take a look at the references below to take a look at the various photos and figures. The figure above is from the Macey 2002 paper)



Canessa, N., Castronovo, V., Cappa, S. F., Aloia, M. S., Marelli, S., Falini, A., et al. (2011). Obstructive Sleep Apnea: Brain Structural Changes and Neurocognitive Function before and after Treatment. American Journal of Respiratory and Critical Care Medicine, 183(10), 1419–1426

Henderson, L. A., Woo, M. A., Macey, P. M., Macey, K. E., Frysinger, R. C., Alger, J. R., et al. (2003). Neural responses during Valsalva maneuvers in obstructive sleep apnea syndrome. Journal of Applied Physiology (Bethesda, Md. : 1985), 94(3), 1063–1074.

Kumar, R., Chavez, A. S., Macey, P. M., Woo, M. A., Yan-Go, F. L., & Harper, R. M. (2012). Altered global and regional brain mean diffusivity in patients with obstructive sleep apnea. Journal of Neuroscience Research, 90(10), 2043–2052.

Macey, P. M., Henderson, L. A., Macey, K. E., Alger, J. R., Frysinger, R. C., Woo, M. A., et al. (2002). Brain Morphology Associated with Obstructive Sleep Apnea. American Journal of Respiratory and Critical Care Medicine, 166(10), 1382–1387.

Macey, P. M., Kumar, R., Woo, M. A., Valladares, E. M., Yan-Go, F. L., & Harper, R. M. (2008). Brain structural changes in obstructive sleep apnea. Sleep, 31(7), 967–977.

Lal, C., Strange, C., & Bachman, D. (2012). Neurocognitive impairment in obstructive sleep apnea. CHEST Journal, 141(6), 1601–1610.


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

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

46 thoughts on “5 Areas of Brain Damage Caused By Obstructive Sleep Apnea

  1. I am am 33 year old respiratory therapist and been on CPAP for over a year. I do not snore at all when I sleep. My sats NEVER went below 95% during any sleep study I have had. I NEVER wake up short of breath or gasping for air. When placed on CPAP, I truly thought it would make things better…I was FAR from wrong. I tried over 20 different masks….EVERY one broke the skin down on my face no matter what I tried. Next, my (now ex) fiance would tell me I would kick, toss, shake and turn in my sleep. Something I NEVER did NOT using CPAP. Numerous nights I woke up with the tubing wrapped around my neck!!! I felt soooooo much worse in the morning sleeping with the CPAP…like I NEVER slept at all…which was true…I would wake up every 1-2 hours with the CPAP (not due to leaks, etc either). I developed horrendous night sweats on CPAP. They would get so bad I could squeeze the sweat out of my pj’s. They also started to get a really foul smell. After 1+ years of being very compliant (to show the doc it wasn’t working and make the insurance company happy), I stopped using it. I feel better sleeping without it. I dropped 10 lbs almost instantly stopping the CPAP. If I have to choose the lesser of the 2 evils…I choose NO CPAP…either way was killing me :(

  2. Stacey,

    Sorry to hear about your bad experience with CPAP. Unfortunately, it’s a common situation for many people. CPAP can be a miracle for many people, but for others it can make your sleep even worse. The good news is that there are many other options available. It’s only a matter of being persistent and trying different options one by one.

  3. Hello,

    Dr. Park. I am so pleased to read this fascinating article on OSA and Memory Loss. I am single, 43 and have recently been diagnosed with Early Onset Dementia. I am actually going for a Spinal Tap today to see if it might be Alzhiemer’s or another type of dementia. I have had untreated OSA for many years and never knew it as I am a bachelor. I have noticed my memory going for several years and actually flew myself to the World Famous Mayo Clinic in Rochester, MN last September (2013) where they actually ran the first sleep study ever done on me. They found that I woke up every other minute in my sleep from not breathing. I was blown away that I had no idea this was happening at home. They also ran neuropsych test on me and my scores we somewhat poor and I left with a diagnosis of mild cognitive impairment and a cpap over my shoulder. At that time there was no atrophy to my hippocampus or any neurogenerative disease in the brain. I wore my cpap religiously for 8 months on return to Texas and my energy levels, focus, mood, libido, etc all got better, but unfortunately, my memory did not. I am convinced that my severe OSA being untreated for years played a significant role in my current diagnosis of Young Onset Dementia. My current, Neurologist, ran test last month and there was atrophy in my hippocampus and my neuropsych scores were poor again. I am now wearing an oral mandibular device that moves my lower jaw forward and happy to report that I am sleeping better, but I still have no idea how many apneas a night I might be having. Can you give me any advice on how to detect if I am having apneas at home as and in my own environment as opposed to having to go to sleep study after sleep study? Are there any current technologies, wearables, etc, that will tell me how well I am sleeping at night, apneas, o2 sats, etc? Also, can you give me any info or refer me to any journals on the linkage between OSA and Dementia or Alzheimers? Also, do you know of anyone that is doing Clinical Studies or Research that I might be able to qualify for with OSA and Dementia. Any help and suggestions would be greatly appreciated. Thanks so much.

    Chris C.

  4. I was diagnosed with chronic sleep apnea in 1998, but probably had it years before the diagnosis (we can go back to 1989 when my asthma flew out of control and was on long term steroids.) I eventually soared to an amazing 143 apneas an hour, and had weight gain that could’t be controlled. I eventually I had to stop driving, my head was in a dream-like state most of the time (I could not concentrate on conversations), and my perception (even when walking) was compromised. How I was able to work is beyond any of us, except I credit a very forgiving boss (who “built” a bed for me under my cubicle because I drifted off to sleep so often), and a job that could be done by keyboard memorization. Even with a bi-pap, I still spiraled out of control, and eventually had 24 hour oxygen therapy also (my oxygen level plummeted to the low 70’s, and I even experienced apneas during the waking hours). There were a few operations done to try and reduce the bulk of my tongue, including moving my tongue forward, and a few other techniques that I can’t pronounce or even spell. I had a therapist who was keeping me sane with depression and meds, he was even counseling my son for my impending death (this same dr. was also actively finding a family my son could go live with eventually). The team of doctors i had were working to get gastric bypass approved, but that stalled until finally in 2000, when the insurance company started looking at bypass as a non-cosmetic operation. It is what saved my life. CPap, BiPap, where all helpful to some degree, but with such a chronic case, it was only a temporary technique. My 170 lb weight loss stopped my severe apneas, and now, almost 15 years later, even tho I have gained 50 of those lbs back, I still only have upwards to 8 apneas an hour. When people tell me they have apnea, it takes me back to the absolute horror of feeling my body break down – after I started to heal a bit, one doctor told me how close I was to death, he remarked at how much of a shell my brain was (I literally could not hold conversations or even comprehend discussions near the end of all this). I cannot tell people enough who have apnea – don’t let it get so bad there is no way back. Lose the weight if you have to. Fight for your life. The brain suffers so much when it gets bad, and I sadly realize they do not, can not, even comprehend how severe it really can be.

  5. I have tried to be persistent. Being an RT, I know the risks, side effects, etc. I am in the process of finding a new doctor that will do more than just increase my pressure from 6 to 8, and say for 8+ months about a dental device, then tell my PCP about a trach!!!! I work with primarily trached patients. I tried to bring up a fairly new treatment similar to a phrenic pacer, and he didn’t seem to want to hear about it :( I think I was looked upon as exaggerating and not taking it seriously, when the SD card showed I was using the CPAP consistantly. The last 2 months I have slept without it, and sleep better. I still feel like hell, but not as bad with the machine.

  6. I am 59, I was concerned about early dementia. I have had my Cpap for 5 months. My memory has improved, but not 100%. I am a RN and two weeks ago, I could not get my patients name straight for the life of me. I was so afraid of harming. The night before my mask did not seal well and I also suffer from chronic pain. Now for some reason even with the Cpap on bad sleep nights my memory is horrible.

  7. I have been utilizing my CPAP for about a year. I do feel more rested in the mornings and no longer wake up feeling like I have a headache. I found it very interesting OSA can cause memory loss. I am 43 and have noticed a significant decline in my ability to remember information for both the long and short term.

    I will speak to my doctor about the possibilities of checking my hippocampus and mammary bodies. My fear is confirmation of damage and no way to correct it.

    Does this condition worsen with time, are there treatments or supplements to assist in recovery or slow the deterioration? Are those of us with OSA doomed to encounter early dimentia or Alzheimer’s?

    Thank you for publishing the article. Those of us with OSA truly appreciate the information.

  8. Chris,

    Glad to hear that you’re sleeping better with your oral appliance. Your dentist should be able to coordinate with your sleep physician to have you undergo a home based sleep study to make sure that your apneas are significant better. This is a strongly recommended step any time you use an oral appliance. Regardless of whether you use CPAP or an oral appliance, you have to give it some time before reassessing brain function or imaging. This may take months or years. There’s no formal study linking OSA to Alzheimer’s since dementia researchers think it’s a completely unrelated condition, but there are ongoing studies that are likely to connect the dots. The challenge is that not everyone responds the same way to OSA treatment. Some people do very well with CPAP, some get no help, and others may feel worse with CPAP. It’s important to go through the troubleshooting steps with your DME. The same applies to oral appliances. If one doesn’t work, you need to keep trying other options, including surgery in some cases. Good luck.

  9. My mom says that when I was a kid I would recite whole books of the Bible from memory. I was a straight A student that loved to read. I was the ten year old that teachers were already asking my college goals. But I was always tired and at age 13 I stopped understanding things so well. My grades began to slip and I was too tired to ask questions. I started falling asleep everywhere I went. At parties I would sneak off and find a random spot, on any surface…to sleep. I wasn’t able to finish public school and left school in the middle of the seventh grade. Later I enrolled in a correspondence program and finished school at home in between naps. Then, as an adult I developed insomnia. Quite the opposites. The main thing I notice is not being able to remember names and directions. It’s sometimes embarrassing. I found out I had sleep apnea about two and a half yrs ago. I tried CPAP but it gave me apneas that were unrelated to obstructive apnea. I would stop breathing even though my airway was open and I woke up a lot. I tried it for a year with four or five different masks. Then I tried an oral appliance. But it wasn’t until recently, after tongue tie and sleep apnea surgery that I’ve starting loving to read again and for the first time…loving to LEARN. It hasn’t been nearly long enough for my memory to improve much yet, and I still have embarrassing moments. But my husband says that I’m more creative. Also I’m enjoying a new hobby…cooking! For me to learn something new is quite a milestone. Thanks for this interesting article and for the opportunity to share my sleep apnea story!

  10. As usual our little team of cooks (3 on this shift) was in the process of preparing to feed a couple of hundred people. Time is precious, organization essential. If you do it right you set up, do your task (interweaving it with others in process) then clean up. But I had forgotten something.

    So I began the process of going to get what I needed. Then I thought it would be better to go to all three places (cold storage, dry storage, the dish pit for pots and pans). Then I get back to my station and find that .. got (nearly) everything I needed .. except !!

    The third time around this loop my work mates asked me what in the world was going on. To this day I do not know exactly how to describe it. I know that I would “remember” something I would need later in the day. And I would be memorizing things for future times. But I would often forget what I had interrupted my project to get in the process going to get it.

    And telling myself to concentrate harder did not help.

    I knew what might help. A break.

    Perhaps this kind of set shifting (working memory) problem was why some days projects took three times as long. I know my work mates hated to see me that way!!!

    I kind of doubt they would have liked to see me taking a break when I had such a day. I never dared try it.

    But it did not happen every day. The thing that drove me crazy it that I could not really predict exactly when it would or would not occur. And often I was not really aware of it when it was happening. In the general sense if I was dealing with more stress the working memory problems were more likely to occur. But it was simply not predictable.

    So people would see me on a good day and think I am OK. I wish it were so.

    One thing that seems to be forgotten in almost all research concerning sleep apnea is that everything varies every day. You really cannot take a “snapshot” of the situation and think that you understand what is going on.

    Yet that is indeed what they do. With sleep testing they might make their decision about your sleep apnea based upon only a few hours in a laboratory. Yet I know from looking at hundreds of nights of my own CPAP airflow data that things can greatly change over the space of a day or few days and that they will be different every night. I do believe that our methodologies regarding sleep testing need to change. We need to see data from several days in the home with full data from self applied hardware.

    And the testing of the cognitive deficits caused by sleep apnea also needs to change. Who cares about how I do in the laboratory or doctors office. Who cares for goodness sakes. It is how I do throughout the day dealing with real problems that matters. Ever hear of GoPro? Wire up the workplace. Find out what really happens. It is frankly the only way to find out. And we need to know.

  11. I agree completely with Tod Medley. Simple tasks have become impossible for me. I now live with a tracheotomy, but suffer still from daytime fatigue. Even with the trache I have mild sleep apnea, it’s not central sleep apnea.

  12. I have been suffering from weird anxiety that lasts all day and I didn’t sleep well this has been going on 8 years last year I got vestibula nuritis and was really messed up the doctor sent me for a sleep study in this time they found I have mild sleep apnea and don’t get much rem sleep they said I could go on cpap but they didn’t sound to concerned aroun that time I got a MRI it came back clear in may this year I got the dizziness back the doc said it was VN but sent me for a MRI this time it showed that some of the blood vessels were dead small vessel deisease I’m really scared I’m only 30 so I went back to the sleep people and got on cpap it’s been a week I find it uncomfortable and rip it of somtimes while I’m asleep my anxiety is alot better I am still dizzy and have head aches and a feeling of diss realization will cpap fix my brain or am I heading for dementia I don’t want to be 40 and not no my kids names please help

  13. Hello Doctor Park,
    I am not certain how long I have had damage from sleep apnea. Some symptoms may have been evident since 2001. I had returned to school in 2008 and was able to maintain a 4.0 thanks to a great long term memory. I could recall word for word an hour long lecture. That joy was shortly lived as my memory rapidly grew worse and worse. It was just a few years later I could not recall what I said in a conversation and after loosing a job in a call center because I could not remember what I was talking about or what a person said I knew something was severely wrong. Besides the massive amount of mental fog my body was in much pain. Initially we thought it might be fibromyalgia so my doctor gave me some medicine and sent me to a sleep doctor to check for sleep apnea. After having a sleep study done it was confirmed I had obstructive sleep apnea. After three months of dedicated CPAP treatment I have noticed a change my ability to focus and understand a conversation and be able to recall and understand much more than a few months ago. I still notice my mind getting mentally fatigued still and my body still has some pain but nothing like I had before. I would love to do some memory testing to see how much it has improved. I am able to remember a series of instructions better and have noticed some photographic memory returning. So I think alertness and memory is much improved but has much more to go.

  14. I have central apnea, I’m 42 yrs old, at age 37 I started waking up with bad headaches that got worse until I was diagnosed with C.A. at an average of 90 hypopneia incidents per hour, but was initially treated with a machine that removed carbon dioxide from the air and put the remaining oxygen into my nose, through tubes…apparently this “tricked” my brain into thinking that I was still breathing after stopping, resulting in my vomiting blood and going into a coma for five days… Then I switched doctors and was put on a VPAP machine and have been on one since, with varying degrees of success, though my AHI is almost never below 7 or 8. My memory has gotten so bad that I have been telling family members and my doctor that I feel like I have early onset Alzheimer’s, my Grandmother has a horrible case of Alzheimer’s, my father, her son, has Obstructive S.A. and both him and I had prostate cancer at a young age, his at 50, mine at the incredibly young age of 39 when I had a prostectomy. Reading this article is making me think that it’s all connected but doesn’t give me much hope for the future, especially as a father of six, including my younger son who I raise alone. Do I have any hope or something I can do to help myself other than using the VPAP? It definitely helps but is FAR from perfect….

  15. In response to the post by Brendan Delaney on August 17th, 2015 6:54 pm –

    I long for the day that those involved in implementing CPAP will both understand and respond to the ventilatory control issues which often birth carbon dioxide maintenance issues which often make themselves part of the CPAP use scene. Apparently very predominately in your case.

    In my case I have come to believe that I have insufficient posterior communicating arteries feeding my basilar artery. This makes the blood coming from the vertebral arteries critical. But I also know that when I do neck exercises I often hear arthritic snapping and popping going on. And after that snapping and popping a feeling of relief. Perhaps the blood supply from those vertebral arteries threaded through my neck is indeed compromised intermittently.

    The neck exercises were created to make the arthritis in the neck less (I know this works for my knees). I continue to find them useful and do them regularly. I am also working to correct forward head posture / upper cross syndrome. If I find my breathing to be more than it should be for what I am doing (often bringing on a stuffy nose or sneeze) correcting the forward head posture consistently almost immediately stabilizes my breathing back to the quieter normal levels. This works standing up or in bed.

    I think that anything that I can do to detoxify my body and eliminate the toxins that drive inflammation and likely the arthritis will help make more room for the vertebral arteries to allow more good blood flow. Along with the many other things I am doing to detox I have discovered that taking activated charcoal in water two hours after eating anything[a] and just before bed time serves to lessen time to get to sleep, results in sleeping through the night more consistently, and I find that my breathing is what it should be waking up (breathing not heavy, no dry mouth, no cold feet, no high heart rate, and no aerophagia .. simply a calm morning wakeup).

    I also have applied ground flax meal / activated charcoal poultices to my neck to help with this. This I think actually seemed to increased inflammation for a short time but then made things much quieter during exercise and better in general. Perhaps clearing out some toxins in the neck allowed the immune system to notice a pathogen and what I noted was the response?

    I think that anyone having trouble with ventilatory stability while using CPAP would do well to learn how to and indeed detox.

    [a] Please also note that activated charcoal will likely adsorb any medications taken close to it’s ingestion.

  16. Before undiagnosed, untreated OSA derailed my life, I was a psychologist with a particular skill in diagnosis.

    I am convinced that untreated apneas are ONE cause of dementias/Alzheimers because I’ve been in the doorway and been able to back out a few feet. The fear persists that it will return.

    There are many people like me. And many of them are women, because women are UNDERDIAGNOSED. I don’t buy the 1/10th statistic at all. The stereotype of the overweight middle-aged male needs to be erased from clinician’s mental imagery. We are everywhere.

    PAP treatment helped but did NOT fully restore my brain/frontal lobe functioning. An experiment about sugar and wheat (gluten) confirmed for me that those two had a bad effect on my brain as well. Without eating them, I definitely do better — if I am also sleeping better. It takes both to be able to function almost normally.

    However, now that the OSA is treated, apparently CAs are now 90% of my events, and the sleep doc keeps wanting me to take acetazolamide despite the fact we haven’t looked into the other potential treatments, like the lower-venting masks, tweaking my pressures (post-nasal surgery, I think lowering the pressure might be helpful now).

    Your website is one of the most helpful I have found — thanks for sharing so much great information.

  17. I have been having severe problems breathing at night for several years. It felt like my breathing was shallow and I be aware of waking up to 40 or 50 times in a night having to sit up and blow to try and get my breath. After years of asking my GP to arrange for a Cpap or bipap with no joy, I saved up to see a sleep consultant who referred me for a polysomnograph. It showe what I have been trying to tell my doctor for years that my breathing is terrible, I constantly wake up etc.

    Prior to developing sleep related breathing issues I was studying science and mathematics, involved in freelance investigative journalism and enjoyed great conversations with my friends. I no longer do any of the above, I muddle words, forget what I am saying during conversations, have greatly reduced intellect and have a horrendous memory. I have also developed diastolic dysfunction for which I was prescribed furosemide.

    I am due to start CPAP in a couple of weeks (just waiting for cough to go), I am really hoping this will help my mind go back to how it was, I will update after having CPAP but would be interested (in a desperate type of way!) to know if brain damage or cognitive (took me a few minutes to remember that word after going through every co…..word I could think of!) function is returned once you have treatment?

    By the way about 6 years ago ( year or two after it started) I had a brain scan fr something, as sleep/breathing issues has been consistant every night for these 6 years since scan, would any damage done from continous hypopnea/sleep apnea over that period show on an mri if I had one now?

    Thank you for taking time to read this.

  18. Sam,

    Sorry to hear about your health struggles. Studies using functional MRI show that damaged areas of the brain can regenerate, but to various degrees. Furthermore, you can have severe brain dysfunction without seeing anything obvious on imagine studies. What’s more important is how well you’re able to function.

    Best of luck with your CPAP treatment.

  19. Thank you for such a quick response.

    I shall keep everything crossed as function wise I’m not doing very well for the past five or six years so to have that change would be ife changing.

    Thank you.

  20. I have sleep apnea and have been using CCAP Machine for a few months. Lately I have been getting heart palpitations during the night and even during the day and sometimes feeling out of breath and lightheaded. I also sometimes feel confused and my concentration is off. Could I have suffered some damage to my brain that could be causing these issues? I have heard that using the CCAP can reverse some damage to the brain. Will an MRI show areas where there is brain damage?

  21. Nancy Prestigiacomo (NP) on December 21st, 2015 9:56 pm said: “ I have sleep apnea and have been using CCAP Machine for a few months. Lately I have been getting heart palpitations during the night and even during the day and sometimes feeling out of breath and lightheaded. I also sometimes feel confused and my concentration is off. “

    Nancy I am all to familiar with the fact that the way that CPAP treatment works for me does not stay the same. That is indeed because I do not stay the same.

    Let’s say that the CPAP machine is working for you. Well now, your body will begin to heal. Your body will change. Breathing will likely be affected.

    But for me “heart palpitations” (high heart rates in my case), “feeling out of breath”, along with “lightheaded” and “feel confused and my concentration is off” would indicate that I am tending to hyperventilate – which the pressure of CPAP tends to exacerbate.

    When I have experienced this the worst is was at times close to the anniversary of a serious assault and robbery upon my person. Using EERS helped, eucapnic breathing retraining also helped. It seems to be largely related to how well circulation is working in my body so moving from a beta blocker (slows the heart and reduces overall circulation) to an alpha blocker (reduces blood pressure by opening up the blood vessels facilitating more circulation) helped. The assault happened in the middle of November and I live at a high latitude where D3 production through sunlight is not possible sometime past September. I have found that moving my D3 levels up helps and do now strive to establish them between 60-80. Moving toward a consistent active lifestyle status helps. Learning to eat well helps. Mindfulness meditation helps. Acupressure, reflexology, and acupuncture also help. As part of the blood supply to the brain passes through the neck vertebrae I have also found that doing neck exercises along with correcting forward head posture also does help. I share in my little “blog to be”.

    NP said : “Could I have suffered some damage to my brain that could be causing these issues?”

    After spending many hours in the medical papers I would say that I believe this is a real possibility. The amount of damage appears to relate most to the lowest blood oxygen level measured during the sleep study and the AHI.

    NP said : “I have heard that using the CCAP can reverse some damage to the brain.”

    Some, yes. If it is managed well (I often use SleepyHead to check my nightly CPAP data) it may help facilitate healing. As will most all of the items that I mention in my previous paragraphs here.

    NP said : “Will an MRI show areas where there is brain damage?”

    The kind of MRI studies which show this are fMRI specifically calibrated to look for very specific damage in the brain or metabolites used as indicators. Last time I looked into this (several years ago) the “well above $3,000.00” price tag made this a “no go” for me.

    Sensing what is going on in the brain is a science with a high development rate right now. More to come in the future I would think.

    I have come to believe that CPAP treatment works much better when it is only part of the things done to improve.

  22. This is aimed at stacey or anybody here who decided to stop using their CPAP machines or are thinking about it. You are making a serious life changing mistake to ever consider this or do this. Look up the long term health complications of OSA. They are very severe and miserable and you are going to walk right into them if you do not use your machine.

    This is coming from somebody who took a month to get used to his CPAP machine. When I started, the mask was uncomfortable. I had difficulty sleeping with it.. But over time as I worked with my CPAP providers for advice and looked up advice I did eventually find the answers I was looking for. Persistence is the key here.

    Now I can barely feel the mask if I wear it and I can go to sleep normally. I can’t feel the air going into me. The doctors told me that you eventually get desensitized to the mask and that is exactly what happened. So if you’re only a few weeks in and its not perfectly comfortable yet thats pretty normal. The point is you will eventually not notice its there and you have to wait for it to happen.

    So what do you do again if your mask is uncomfortable? Stick to it and keep troubleshooting until it works! Don’t give up! Ever!

    Even though stacey had a situation like that she still could have eventually found a way to use that cpap machine.She mentioned the mask broke the skin every time. That sounds like she was tightening it too much every time which made every mask she used uncomfortable because she over tightened it. If she had sent an email to her cpap providers about these issues they would have worked with her to find a good fit to the mask and she wouldn’t have stopped. Now she has possibly lost years of her life and will remain energy deprived for the rest of her life because of this. Don’t end up like stacey! Stacey if by any incredible chance you’re reading this please get back on your cpap machine! There is still hope for you!

  23. I had undiagnosed sleep apnea for thirty years. It played havoc with my professional job as a teacher where I appeared forgetful, inconsistent and incompetent to my peers. It also made family life extremely difficult due to lack of energy and being zoned out a lot. Diagnosis and intervention with a CPAP machine improved my life greatly, although neuropsychological testing short term memory and executive functioning were permanently damaged, which effectively ended my career. So I think that early intervention is critical in preventing brain damage and the resulting disruptions in one’s life.

  24. I am a 32 year old woman. In 2012/13, in my 3rd year at Limestone College, I noticed I was having memory problems. I was going to double major in chemistry and molecular cellular biology, I had taken an overload every semester and was the Chemistry department’s lab assistant through the work-study program, in addition to being a wife and a mother to 4 kids. My grades slowly declined as the classes I took required me to learn/remember new and more complicated things. One day, I sat in a chair and couldn’t figure out how to do logs, I couldn’t even remember that I needed to use a calculator. There were other little memory loss events, like telling my lab partners the wrong ages of my 4 children , I later realized I had told them their pant sizes. My grades dropped from a 4.0 to a 2.3. I new something was wrong with me and had been for a while, but I couldn’t figure out what it was, and I had given up on doctors as they usually tried to put me on antidepressants, birth control, or anxiety meds. Finally my family doctor sent me for a MRI because I was complaining about headaches, they found a large pineal cyst, referred me to a neurosurgeon (who said they weren’t going to touch the cyst), and then I was referred to a neurologist so they could monitor any growth of the cyst. The neurologist also ran a sleep clinic, and after my repeated statements about being sleepy, scheduled a sleep study. My test showed that I was going into Stage 2 sleep, then jumping to REM, I had 0% Stage 3. No deep sleep, was the cause of my memory problems, recalling information and the reason my bruises took over a year to completely heal. The neurologist didn’t tell me any of that, I searched through many studies and peer reviewed articles to find out how OSA effects my health. CPAP therapy has helped with some of the memory loss, recalling of information, and in the about of time it takes my body to repair itself. I’m not completely “fixed”, but I am extremely grateful that it has helped.

  25. When I was 24 I started feeling awful, always tired, waking up unable to breath at all (which have resulted in occasional seizures), high anxiety and forgetting basic words like what my hand was called. Also I was always scared during the day that I’d stop breathing, especially when I yawned or sneezed. The doctors took about two years to diagnose severe obstructive sleep apnea. I was young and was a healthy weight, so I guess that didn’t help to diagnose it quicker.

    I had major surgery including a tonsillectomy, uvulectomy, pharyngoplasty and tongue shrinking. This helped me a lot for a while and I felt great. However, symptoms started to pop up again and another sleep study showed that I had severe central sleep apnea. I went on a bipap machine and it helped a bit but after a while I began waking up with bad headaches and waking during the night and having to take the mask off. Soon after I stopped wearing it completely. I started to wake up more refreshed and my partner has noticed that I am breathing much better, and thankfully it’s been months since I have woken up without being able to breath.

    It seems as if my brain is slowly learning how to breath again, but I’m pretty sure I have some brain damage. I’m always tired, I have frequent headaches and brain fog, weird mood swings and memory problems. I realise that things are getting better, although very slowly. It’s such a relief to see articles like this that give me hope that sometime I will get better and be able to live life again rather than feeling like a prisoner in my own body.

  26. I have had sleep apnea for many years, when I went to the Dr lipson, he told me that it was in my head, can you believe this, finally got a referral 3 years ago, but had problems with the agency who administration, trying the nose, did not work, they were very much against me, now that I have been using the CPAP machine, for 3 years, I am feeling much better, what I have been through with the medical profession and community, I could write a 10 book story,

  27. I am an 50-year-old woman just diagnosed with mild sleep apnea. I have been extremely forgetful, exhausted, and moody since I gained about 70 pounds after having my first child 11 years ago. I routinely forgot entire conversations, where I put things, where I was going, and even how to spell my son’s name. After a single night using my cpap, I could not believe how awake and alert I felt in the morning. I had never felt this good in my entire adult life. I have been using the machine for 6 weeks now, and I feel refreshed every single morning. I am still forgetful, but my mood is much improved and I dont get sleepy in the afternoon anymore. I am hoping that over time my memory will improve. Also, I had suffered with nightmares for years and often woke up shouting, and now I literally have pleasant dreams every night.

  28. I have extreme osa and have been having problems with memory. A MRI revealed atrophy in the front/top of brain. They also found a tumor in the area of the atrophy (not pressing on the brain but right next to it). Needless to say I’m quite frightened. I am calling a highly rated neurologolist today and am hoping to get in right away (although not too hopeful with it being the holidays). Seeing I’m not familiar with the brain… do any of the problems you mentioned in your article show atrophy in the top/front of the brain?

  29. I’m 32 years old and using CPAP for one and a half years religiously. As far as I can remember I only had three days without it. I use to have 38 apnea events per our. As far as I remember I was the emotional sensible reactive kid and a lot of other stigmas. I tried ADHD treatment and it was tragic. My life changed radically but I have difficulty to find my path in life. I always had difficulty to sense the time passing by, concentration, remembering names, social interaction and so on. Now I’m struggling to find my own path after two college attempts.

    I tried group therapy, psychoanalysis and now I will try cognitive behavioral therapy.

    I sometimes am so open to experiment on new things that I would try on psilocybin or sush thing because of the proven stimuli to the neuroplasticity. But at the same time I don’t want to take risks. At the same time I’m convinced that pure psychotherapy I thing has his limits.

  30. I wish I could say that my memory and focus has improved since treatment but that would be a lie. It’s so painful and frustrating. my brains seems to function at only half its former abilities. I love to write , but since the apnea messed up my brain i’m far less articulate, I can’t remember anything and I can’t focus.

  31. I am a 54 yr old Male. I was diagnosed with severe sleep apnea in August 2016. I had two sleep studies. One in the home and in a lab. I was then given an auto CPAP machine. Which ramps pressure from a 5-11. I have now been using the machine every night since late August (6-10 hrs/night). I have noticed better memory (but still not at a normal level), allot more energy, much better blood pressure, much less day time sleepiness, less anxiety, and less depression. The neuropsychologist who tested my cognitive abilities said that after testing that I had severe brain damage. I am now scheduled to get a full brain scan MRI. I have also gotten extensive blood work and a heart ultrasound. Those came back as “normal”. Since using CPAP therapy I have seen improvements in my mood, memory, and overall energy. The doctor said he thinks that my brain damage can be reversible. Maybe not 100% though. I am thankful to my Wife who demanded that I get tested. I am glad I did. I would have much more severe problems if I let this go undiagnosed. As it is, I had this condition for 10-15 years! I hope my information helped!
    Thank you!

  32. Sleep Apnea causes Vascular Dementia. I am 38 years old and was diagnosed last year with Vascular Dementia, due to low oxygen from severe sleep apnea. I wish there was more research and awareness.

  33. I’m 54 years old and I was recently diagnosed with OSA– 88 incidents an hour. I wish I had gone to the doctor years ago. I have only been using my machine for a little over a month but I have felt amazing since I started using it.
    It took a few nights to get used to my cpap machine. I only got about 2 hours of sleep for the first few nights. However, the sleep that I got was deep and very restful.
    I have since been able to sleep between 6 and 8 hours a night – without all of the bathroom trips that I used to wake up for! I feel amazing and have more energy and clarity than I have had in years. I feel like I have had a veil removed from my brain and just experience and see the world so much differently now!!!

  34. Hey all 33 years old and diagnosed with sleep apnea back on January, 6 months after cipro poisoning. I’ve spent the last 8 months trying to avoid cpap and trying to get rid of the mild apnea which I think is caused by the oxidative stress and inflammation caused by cipro but with no improvements. In fact I am now at the point where my personal and work life has suffered, all of my symptoms are worse and I am mentally, Physically and emotionally exhausted.
    Well I finally went in and got a cpap machine today and I guess am looking forward to trying to restore back to my old self.

    I have brain fog like crazy, short term memory is horrible, tired all the time no matter how long I sleep. Do you think 1 year of untreated apnea could cause alot of permanent damage ? I’m really hoping the machine gets me back to where I was a year ago before this all started.

  35. All my life (since childhood) I have had an irregular sleep pattern: when I go to sleep every night, I sleep for 2(+/-) hours and then wake up (very short period of time, but I’m fully awake for that time) then go back to sleep. The cycle repeats until morning comes and I have to get up to start my day. Sleep Apnea was diagnosed (at age 58), and I got a CPAP machine. That cured my (very loud) snoring, but did not change my sleeping pattern at all. All my life, I’ve had horrible memory/concentration problems, also poor motor skills and coordination. The family “joke” is that when/if Alzheimer gets me, no one will know the difference. During my sleep test, the doctor who tested me did say I had a very high number (300 +?) of Sleep Apnea incidents that later my CPAP machine reduced to less than 20. So, my question, if my CPAP machine works so well, why do I still have my abnormal sleep pattern cycle?

  36. Hello, my problems started when I was a small child of about 6 or 7 years old. My father used to bring home various types of chemicals and heavy metals. Both my 2 sisters and myself used to play with the elemental mercury for hours at a time. In the late 1950’s nobody knew about the toxic properties of mercury and I was always at the Doctor’s surgery with complaints such as severe headaches, nausea and vomiting. Most of the glands in my body were always very large. I had repeated episodes of tonsillitis and severe conjunctivitis with purulent discharge and lid sty’s.

    One of the worst things was the bronchiolitis and difficulty breathing. I remember on several occasions my body was very stiff as if I had poliomyelitis. I could not read properly and was always in the bottom stream in the school and because the teachers then wrote on the black board then when the pupils were finished writing the prose down it was rubbed off for the next piece to be put up. Because I had problems with my memory, I never ever caught up with the reading from the board so missed a large chunk of what was being written.

    In 1985 I got a chance of becoming a Mental Health Nurse and qualified in 1987 as an SEN (MI) nurse. I was working on a care of the elderly assessment ward and 2 years after I started working there I found 2 broken sphygmomanometers and all the mercury floating around in the bottom of the cases. Colleagues had some unusual ailments whilst they were working there too. I developed acute atrial fibrillation and needed urgent cardioversion, then was diagnosed with Obstructive Sleep Apnoea so started treatment with CPAP. My sleep study showed that my airway collapsed 800 time during the sleep over. My snoring was very loud until CPAP commenced.

    I continued my nursing career but I had several affairs during the time 1990 tp 2002 and felt no inhibitions with regards to them at all. At this time my career started to deteriorate and kept getting reprimanded for not doing my work as it should be.

    After one of these affairs I was in fear of my life because the boyfriend of the woman that I was seeing was a criminal and moved around in the criminal world. I was threatened. I moved away and got a job in Scotland. My poor record of nurse management continued and my memory got worse. More disciplinary problems kept coming my way. In 2008 I had an incident with a male patient and got my arm injured and could not work for months. One thing I forgot to say through out this report is that I suffered on and off with endogenous depression. During this spell of off work with sickness my wife got quite worried regarding my mental health again. I kept losing things not once or twice but continually. Keys, wallet, car, names, places that I had been and knew well. Words would be lost when I was having a conversation. I could not coordinate specific problems and would get frustrated. From being laid back and calm my behaviour became hostile and unpredictable. I could not organise things. I was a heart start trainer and knew the practical side of the training perfectly but when it came to explaining what to do, I had big black holes in my vocabulary. I told my coordinator that I had a problem so we worked around it by him doing the talking whilst I did all of the practical.

    I got quite worried and went to my doctor mainly because I was at the surgery every week with something new or an older problem that kept coming up and getting worse. My complaints or illnesses are vast and getting longer and longer as the weeks and months went by.

    I asked my GP to refer me to the memory clinic and I got to see a CPN who conducted an Addenbrook’s Ace3 test. on completion I had scored 77 so was sent for a brain scan. I also went to see a neuro-psychologist and had a variety of more tests. I was waiting for a year for my results. One day I got a letter from a locum psychiatrist who was with the care of the older persons team. I saw her and she was not happy to find out that I had not been seen.

    She broke the news that I was suffering from Frontotemporal lobe dementia. I was put on a short 3 month course of an acetylcholinesterase inhibitor which I took for about 2 months. Only to come off it because of some particular nasty side effects. I was having very vivid dreams where I was in the dream and I could feel everything that was happening to me. I am now waiting to see the psychiatrist again to be prescribed Menantine. In the mean time I am still having bouts of swallowing problems where I choke on food and drink plus My hearing is getting worse. Thank you for listening.

  37. I have been using a Bipap for about 3 years and am not getting a good night asleep, due to airflow mostly. For some time now I experience a sense of not being able to think clearly. It feels like my brain just fogged up, and this feeling persists to at least noon, usually.
    Have been tested for oxygen during the night and O2 levels are reported as normal. I am starting to wonder if this problem could be the start of dementia. Anyone experiencing the same?

  38. I have been using a CPAP machine for many years. I have recently developed AFib. I started having phantom smells when I would smell baking chocolate chip cookies so I was given an MRI of my brain. It showed that I have pockets of air at the base of my brain. I use a mask that covers my mouth and my nose and seals tightly. Could the air in my brain come from the constant input of the air at night?

  39. I was originally diagnosed with sleep apnea 6 years ago. What got me into the doctor’s office originally was on 2 different nights I believe I had seizures in my sleep. After wearing my cpap for only a short while I notices a huge improvement. I wasn’t really good, but definitely better. It took 3 more years of going to a sleep specialist for him to finally question why I was still so tired. Finally, at 46 years old I was diagnosed with narcolepsy with cataplexy. After being treated for 2 1/2 years with stimulants and ‘knock me out’ night time medication I’m finally wrapping my head around the fact that something else is wrong – with my head… I’ve always had trouble with memory so I thought this was just normal for me. It’s getting worse. In the past month while driving I’ve realized that I don’t know where I am. I don’t recognize the homes, yards or whatever. To the point that I’ve turned around and driven back only to realize that I am on the right road and this is the road I’ve driven probably 1,000 times this year alone. I forget to shower. I get up with every intention but then somehow it’s 2 hours later and I don’t know what I’ve done with my day other than piddle around the house. I can repeat something I have to do 50 times to myself and the moment something distracts me I don’t even think ‘now what do I have to do?’ anymore. It’s just gone. I write down lists and reminders and forget that I have them. The only thing that helps is putting alarms in my iPhone. But it only takes 1 thing to distract me and it’s gone. I forgot to get my prescription filled today. I just realized it. Dang! Is this Alzheimer’s or dementia? Do I see my family doctor? What started me looking into this was last night my 19 year old daughter told me that she wants me to go to the doctor that something is wrong with me. She wants to go with me because she knows I’ll forget to tell them everything. I could tell she was afraid and it makes me so sad for her. I’m not working but I have to get work soon. I worked for 6 months at a local home improvement store and missed work several times because I forgot to go. To be honest I’m afraid of getting a job because I’m afraid I’ll do this and get fired. I’ve never been fired before and I’ve always been proud of my work ethic. Help! I don’t know what to do. I’m 48 and have 2 daughters, one is 11 and the other is 19 and I need to be here for them. Any advice would be so very greatly appreciated!

  40. Rest and rest, don’t feel guilty, reach out for help so you can rest.
    Then they try to comply to your doctor’s recommendations with regards to sleep apnea. I have come all the way to after the surgeries, and had a tracheostomy. I was too late and suffer still from the damage done earlier. Take it very seriously.

  41. Hi, I was diagnosed with Obstructive sleep apnoea about 30 years ago and started treatment with CPAP. My partner at the time had real problems sleeping with me because of my very loud snoring and stopping breathing for several seconds at a time. She sometimes jabbed me in the ribs and I would take a large breath and go back to snoring and sleep?
    I was referred to the sleep speciality at my local hospital by my occupational health department, because I was working as a mental health nurse with the NHS. During the sleep study I was all wired up to the machines and went to sleep. In the morning I was given the news that the test showed that I had sever Obstructive Sleep Apnoea. The graph showed that my O2 levels went down each time I stopped breathing and over the period of about 8 hours I stopped breathing 800 times. I thought no wonder I was feeling tired, confused and had problems with memory loss and managing tasks. I know this because I had many problems with my boss/ward manager for forgetting things that I should have done as part of my general duties as a nurse.
    Since then I have deteriorated functionally. I had to retire early as a result of an incident with a very fit 85 year old gentleman who was suffering Alzheimer disease. He thinking that I was a German soldier. He was trying to break out of the locked ward that I was in charge of during the night duty. As I escorted him back to his room, somehow as quick as lightening he had my wrist over his shoulder and caused me to have a dislocated shoulder and a severe rotator cuff tear, for which I needed an operation to rectify the damage.
    Over the past 3 years I have been investigated for a mental health condition. The first Psycho-geriatrician in the local memory clinic gave me a diagnosis of 1. Frontotemporal lobe dementia Alzheimer type. 2. Alzheimer dementia. 3. Bi-polar disease.
    This was from the CT scan. Then a year and a half later I was given a confirmed diagnosis of Frontotemporal lobe dementia. Now after several Ace111 tests which I scored 77 on the first one then after several more the score was even lower, the locum psychiatrist told me that I just had Alzheimer disease which was down graded to Dementia then to my surprise downgraded to PTSD????
    I was given a Link nurse for a year who assists people with Frontotemporal lobe dementia set out the future of this terminal illness. Now how do you talk to your relatives and tell them that I am not going to die as early as I first thought. To end on this my wife and I are still convinced that I do still have Frontotemporal lobe dementia because my signs and symptoms have not changed they have got worse. I have just had another CT scan and Could I ask because the brain damaged area is vast can the atrophy be missed being so spaced out over the surface of the brain. Your help would be a very great help to my wife and me.

  42. My husband passed away 6 months ago suddenly.i was working the night shift and I came from and found my husband deceased.he was in hes recliner watching TV I’m asuming,he still had hes glasses on the TV was on and he had hes eyes open.the cause of death was cardiopulmonary arrest.my husband had the worse sleep apnea that is for about 5 years.he had the machine at home but he hardly use it.my question is.did he died a painful death?did he passed why he was sleeping?the medical examiner told me hes been death for a few hours before I found him.im tormented by hes passing cause I was working and he died all alone.maybe,just may e if I was home that night I could of saved him.tbey told me he died instantly,cause even I had been home I wouldn’t of have time to call 911.i need to know what happen that night.did he know he was dying?please somebody help me.on to of that when I called 911 they told me to put him on a floor and start cpr.i did but I could see he was decead.

  43. Dr Park I have been diagnosed with amnestic MCI. I am 48 years of age and have untreated OSA, diagnosed in 2014 but estimated onset is 12 years of age when I underwent radical orthodontic treatment that dramatically adjusted the shape of my jaw and face and gave me an incredibly small narrow jaw and bite. I have been a non-smoker and non-drinker all my life and while I am overweight now by about 12 kg, I was always slim and had a BMI of about 21 until the age of 46 when I had a child late in life. My BMI is 27 now and I am experiencing menopause. My neurologist believes I may have early Alzheimers and started experiencing memory decline in 2016. I have been doing a lot of reading on this topic and I am going to get a PET scan in the next few months as my brain scans and MRIs have been normal but of course I wonder if they are looking for the right things. It is all quite concerning as I am young and I have had to give up my profession and work due to my memory and poor executive function. My verbal and language skills have been less affected but my memory, speed of processing and ability to follow instructions is declining rapidly. This is an incredibly interesting topic.

  44. Thank you for this information; it is both useful and scary as a recently diagnosed severe OSA case. I already had high blood pressure and have hypothyroidism. Both being treated with Meds. I January (at the time I was not diagnosed with OSA) I contracted COVID and, in my opinion while not as severe as some, feel, I ‘got off lucky’ (or maybe not)? I had lingering issues of ‘foggy brain’ and don’t believe I slept much at post covid. By the end of March I was at my wits end and decided I should get tested for sleep apnea (I had an inclining because by husband said I snored) but the lack of sleep had never been this severe. I did the overnight at home study and it was concluded that I had an average of 109 episodes per hour although I don’t know how that can be as I lay awake for about 75% of the night looking at the sealing or changing from one side to the other. Since using the cpap I am sleeping well; and where I would usually get up between 2-6 times in the night, I now only get up once in the night. I’m waiting on an oximeter overnight study now and the foggy brain seems to have cleared up however, I still feel that my memory focus is not as sharp as it was; I am 65 and work full time and plan on working for another 5 years. Masks – I have a full mask and some nights it can feel uncomfortable; I am planning on exploring if there are other options for someone like me. I am both a patient and a worker at a huge training hospital but I can honestly say that I don’t feel that I’m being educated at all on current and future expectations for my health, what the cpap machine is doing for me or how I can help myself, change diet or routine or anything at all. It was …. here is your cpap and off you go. With the current state of affairs, I’m sure I’m not the only patient who is concerned that any attention is given to the ‘whole me’ and even though I’m sending proactively my daily still high blood pressure numbers, no one seems to be paying attention. i will continue to do what I’ve started; which is to self-advocate and to do the research for myself. Thank you for sharing your expertise and knowledge!