Is Snoring Harmless for Those with Alzheimer’s Disease?
It comes as no surprise that older people may be more likely to snore. We’ve seen so many cultural images of sleepy seniors to know that, while it’s not true for all older people, snoring is a pretty common development as we age.
So it’s no surprise that elderly people with Alzheimer’s disease (AD) might also be loud, persistent snorers.
But… what if that isn’t just snoring?
What is sleep apnea?
Sleep apnea happens when the respiratory system fails to work properly as we sleep. The vast majority of cases of sleep apnea are marked by very loud and persistent snoring. This doesn’t mean snoring is, by itself, evidence of the presence of sleep apnea. Only a formal sleep study, either at home or at a sleep clinic, can confirm a sleep disorder like sleep apnea.
But it does mean that if your loved one with Alzheimer’s snores, they might be dealing with a separate condition that could be dangerous if left untreated.
There are two main kinds of sleep apnea: obstructive and central.
What is obstructive sleep apnea?
Obstructive sleep apnea (OSA) occurs when the upper airway becomes obstructed during sleep. The soft tissues in the mouth and throat can relax to the point of collapse. While some loss of tone in the muscles of the upper airway is ordinary for anyone in their senior years, it’s when the airway is blocked frequently, for periods of at least 10 seconds, that it becomes concerning. The reduced blood oxygen that results is but one risky outcome.
In people with AD, those lost breaths significantly impact their AD. Drops in blood oxygen caused by OSA create the perfect conditions for the buildup of toxins (beta amyloids) during sleep.1
Research found that over 90 percent of subjects in their study—already diagnosed with mild to moderate AD—also had OSA. Nearly half had severe OSA, which was prominently linked to snoring.2
Also, these people, recruited from a cognitive impairment unit, didn’t show differences in cognitive function based on the severity of their OSA. In other words, those with mild OSA shared the same cognitive severity as those with severe OSA.
What is central sleep apnea?
Central sleep apnea (CSA) rare kind of sleep-disordered breathing begins in the brain. The signals the brain normally sends to the respiratory system (by way of the central nervous system, hence the term "central") to regulate breathing during sleep are disrupted. The body basically “forgets” to breathe until blood oxygen levels drop low enough to create a stress response to reintroduce breathing.
While CSA is considered a rare form of sleep apnea, some research shows that as many as 20 percent of people who have it are likely to experience mild dementia.3
Obstructive sleep apnea is more commonplace
While all forms of sleep-disordered breathing are dangerous, it’s OSA that’s commonplace. Unfortunately, not everyone knows they snore, which is one of best telltale signs of hidden OSA. If a person doesn’t have a bed partner or roommate, how are they to know they struggle to breathe as they sleep?
Other signs of hidden OSA include high blood pressure, sweatiness, extreme daytime sleepiness, gasping for air, frequent trips to the bathroom overnight, waking up with a pounding heart, and dry mouth in the morning.
OSA is also linked to type 2 diabetes, stroke, heart, cognitive issues, memory problems, mood disorders, and a host of other so-called “age-related” concerns. It’s critical to discuss any symptoms and conditions with your doctor to see if OSA is a common denominator. If OSA is present, therapy is essential.
Why treat OSA if you or a loved one has Alzheimer's?
OSA is considered a chronic condition that requires treatment. Without it, many of the characteristic symptoms of AD may worsen, especially cognitive decline.
Some genetic research has discovered that certain markers linked to AD share common features with OSA, such as increased inflammation, oxidative stress, disrupted metabolism, and the amyloid buildup linked to AD.4
Ultimately, the American Academy of Sleep Medicine (AASM) issued a health advisory in 2018 that says, in part, that “significant evidence suggests that insufficient sleep or poor sleep may in fact contribute to the development of Alzheimer’s disease…” and that “obstructive sleep apnea, one common cause of poor sleep, may increase the risk of Alzheimer’s disease.”5
Finally, the AASM writes: “…When sleep apnea remains untreated, the ongoing, repetitive sleep disturbance, low oxygen levels, or other adverse effects such as increased beta-amyloid may contribute to progression of Alzheimer’s disease.” It is their position that treating OSA may help prevent or delay AD.5
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