Associations between risk of Alzheimer's disease and obstructive sleep apnea, intermittent hypoxia, and arousal responses: A pilot study

Cheng Yu Tsai, Sheng Ming Wu, Yi Chun Kuan, Yin Tzu Lin, Chia Rung Hsu, Wen Hua Hsu, Yi Shin Liu, Arnab Majumdar, Marc Stettler, Chien Ming Yang, Kang Yun Lee, Dean Wu, Hsin Chien Lee, Cheng Jung Wu, Jiunn Horng Kang, Wen Te Liu

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Objectives: Obstructive sleep apnea (OSA) may increase the risk of Alzheimer's disease (AD). However, potential associations among sleep-disordered breathing, hypoxia, and OSA-induced arousal responses should be investigated. This study determined differences in sleep parameters and investigated the relationship between such parameters and the risk of AD. Methods: Patients with suspected OSA were recruited and underwent in-lab polysomnography (PSG). Subsequently, blood samples were collected from participants. Patients' plasma levels of total tau (T-Tau) and amyloid beta-peptide 42 (Aβ42) were measured using an ultrasensitive immunomagnetic reduction assay. Next, the participants were categorized into low- and high-risk groups on the basis of the computed product (Aβ42 × T-Tau, the cutoff for AD risk). PSG parameters were analyzed and compared. Results: We included 36 patients in this study, of whom 18 and 18 were assigned to the low- and high-risk groups, respectively. The average apnea–hypopnea index (AHI), apnea, hypopnea index [during rapid eye movement (REM) and non-REM (NREM) sleep], and oxygen desaturation index (≥3%, ODI-3%) values of the high-risk group were significantly higher than those of the low-risk group. Similarly, the mean arousal index and respiratory arousal index (R-ArI) of the high-risk group were significantly higher than those of the low-risk group. Sleep-disordered breathing indices, oxygen desaturation, and arousal responses were significantly associated with an increased risk of AD. Positive associations were observed among the AHI, ODI-3%, R-ArI, and computed product. Conclusions: Recurrent sleep-disordered breathing, intermittent hypoxia, and arousal responses, including those occurring during the NREM stage, were associated with AD risk. However, a longitudinal study should be conducted to investigate the causal relationships among these factors.

Original languageEnglish
Article number1038735
JournalFrontiers in Neurology
Volume13
DOIs
Publication statusPublished - Nov 30 2022

Keywords

  • Alzheimer's disease
  • amyloid beta-peptide 42
  • arousal response
  • obstructive sleep apnea
  • sleep-disordered breathing
  • total tau

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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