https://www.michiganmedicine.org/health-lab/sleep-apnea-cont...
While we're speculating as to causes obstructive sleep apnea is associated with dementia, estimates are that 30 million people have it, and we only invented CPAPs in 1980.
While we're speculating as to causes obstructive sleep apnea is associated with dementia, estimates are that 30 million people have it, and we only invented CPAPs in 1980.
Measures of OSA (Obstructive sleep apnea) are somewhat poor, more focused on the amount of pauses in breathing, rather than oxygen desaturation, which is the secondary measure. Note, you don't breath 100% of the time when you're awake either.
I work in sleep and neurotech, and at a large sleep conference last year, a talk was given about better methods to measure apnea. It was clear these measures would have significant challenges in being adopted because it would result in less people being diagnosed as needing CPAP.
Lastly, the impact of CPAP in improving cognitive function is inconclusive [1]. Not that it doesn't have an affect. It does in some people, but not in others.
[1] https://www.sciencedirect.com/science/article/abs/pii/S13899...
Oxygen desaturation correlates with long-term metabolic outcomes, but correlates very poorly to day-to-day symptoms.
The actual primary cause of symptoms in SDB is microarousals resulting from increased respiratory effort, and sleep studies using 3%-or-arousal criteria report MUCH higher OSA rates than the commonly used hypoxia+reduction in flow criteria, while also having a much higher correlation with symptoms(>60% vs ~17% for AHI), and the problem is not over, but under- diagnosis since people with relatively few apneas(e.g. UARS patients) are rarely diagnosed correctly.
Also, (optimally) healthy people DO breathe 100% of the time during sleep- breathing during sleep is controlled by a different system while awake, and is extremely regular during NREM sleep, with REM merely introducing noise to breath amplitude. Any and all pauses in breathing are caused by sleep disruption.
The only reason why it seems like apnea-based criteria are oversensitive is because obese, older men often DON'T wake up from airway collapse and may be fine at 5, 10, or even 15 AHI. For everyone else, it's possible to have debilitating symptoms at 4 because the actual Respiratory Disturbance Index is 20+.
Goddammit man. People like you are why so many go their entire lives unable to find treatment. If you're working in the field, educate yourself about it. Ugh.
Way too many professionals in the field thinking that they're the first person to think about something when literally millions of people think about this same thing all day every day.
For CPAP to be primarily responsible, we would need a very sizeable portion of the population to be using them, but I think the numbers are less than 3% right?
From the article as to the effect size:
“For example, in the US, among people aged 81 to 85, 25.1% of those born between 1890–1913 had dementia, compared to 15.5% of those born between 1939–1943,”
I'm not saying that CPAPs don't contribute, but they are not likely the main contributors.
(If everybody who uses CPAPs would get dementia, and they are 100% effective at preventing that, the drop would still be ‘only’ 3% of the population)
Zepbound is FDA-approved for OSA.
I wonder if we'll discover that there's actually an endemic deficiency in endogenous GLP-1 production due to some other cause? The usual suspects of environmental contamination or subclinical infection, perhaps.