Early use of CPAP for sleep apnea may reduce risk of Parkinson’s
New research shows benefit with machine’s use within 2 years of diagnosis
People with obstructive sleep apnea (OSA) are at increased risk of developing Parkinson’s disease, but starting treatment with continuous positive airway pressure — with the use of a CPAP machine — within two years of an OSA diagnosis can reduce that risk, new research suggests.
“While our study found an increased risk of Parkinson’s disease [in individuals with OSA], the good news is people can do something about it, by using CPAP as soon as they are diagnosed with the sleep disorder,” Gregory D. Scott, MD, PhD, a study author from the VA Portland Health Care System, said in a press release from the American Academy of Neurology (AAN).
The findings of this preliminary study will be presented at this year’s AAN annual meeting, to be held April 5-9 in San Diego and virtually. The oral presentation, titled “Obstructive Sleep Apnea is a Risk Factor for Parkinson’s Disease and CPAP Mitigates Risk of PD: An EHR-based Cohort Study in Military Veterans,” will be given by Isabella Montano, the study’s first author, also of the VA Portland Health Care System in Oregon.
According to Scott, “obstructive sleep apnea is common and previous research has found when untreated, it is associated with an increased risk of heart attack and stroke.” The new study used data “spanning 20+ years and 20+ million veterans” to evaluate OSA as a potential risk factor for Parkinson’s, also finding a link, per the meeting abstract.
The “results indicate that OSA may be an important, modifiable risk factor for the development of PD [Parkinson’s disease],” the researchers wrote.
Study limitation was not knowing if patients use CPAP machine daily
Obstructive sleep apnea is a condition in which the muscles around the airway relax during sleep, blocking the airway and forcing a person to wake up to breathe.
CPAP is a standard OSA treatment that involves using a machine that’s hooked up to a mask worn over the mouth and nose during sleep. It uses pressurized air to keep the airways open so that breathing is not interrupted during sleep.
OSA causes the brain to get less oxygen during sleep, and previous studies have suggested that people with the sleep disorder may be at increased risk of Parkinson’s. However, it hasn’t been clear whether treating OSA with CPAP can mitigate this risk.
To learn more, the scientists conducted an analysis of healthcare records collected through Veterans Affairs (VA), the organization that provides care for people in the U.S. who were military service members. The analysis used data on more than 1.5 million veterans with OSA and 9.7 million veterans without the condition.
Statistical analyses adjusted for potential influencing factors like age, sex, and smoking status, showed a significantly increased risk of Parkinson’s five years after an OSA diagnosis. Nearly two more Parkinson’s cases per 1,000 people were found among OSA patients than in those without the sleep condition.
Overall, according to the team, the data showed sleep apnea to be a modifiable risk factor for Parkinson’s.
It is encouraging to know that while obstructive sleep apnea may increase the risk of Parkinson’s disease, treating it right away with CPAP may reduce that risk.
Among the veterans with OSA, about 1 in 10 had reported using a CPAP machine.
Data showed that the risk of developing Parkinson’s five years after an OSA diagnosis was similar between patients who started CPAP treatment several years after a diagnosis and those who didn’t use the machine at all. Specifically, in both groups, about nine of every 1,000 people developed Parkinson’s five years after their diagnosis.
But for OSA patients who started CPAP treatment within two years of their sleep disorder diagnosis, there was a significant reduction in Parkinson’s risk. For every 1,000 of these patients, about seven developed Parkinson’s five years after diagnosis.
“It is encouraging to know that while obstructive sleep apnea may increase the risk of Parkinson’s disease, treating it right away with CPAP may reduce that risk,” Scott said.
One of the study’s limitations was the researchers’ inability to know whether OSA patients reporting CPAP machine use indeed used such treatment daily, as prescribed.
“Future studies are needed to follow people more closely after receiving a sleep apnea diagnosis and over longer periods of time,” Scott said.
The research was supported by the U.S. Veterans Administration and the U.S. Department of Defense.
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