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A major new study has found a significant link between obstructive sleep apnea and an increased risk of Parkinson’s disease.
A group of researchers from Oregon Health and Science University (OHSU) studied more than 11 million veterans age 40 and older who had never had Parkinson’s disease.
Some of them had been diagnosed with obstructive sleep apnea, a condition where breathing stops and starts during sleep. The researchers then tracked those who developed Parkinson’s for an average of nearly five years.
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They also examined veterans who started continuous airway pressure therapy (CPAP) within two years of their sleep apnea diagnosis, looking for any differences in Parkinson’s outcomes compared to those who never started CPAP.
Dr. Greg Scott, an Oregon-based physician and author of the study, called the discovery “surprising” in a press release.
The study analyzed more than 11 million veterans age 40 and older, with an average follow-up of five years. (Stock)
“People who had Parkinson’s but were on CPAP had fewer, fewer deaths and lower mortality. We tested this rigorously and the effect was consistent,” he said.
The study, published in JAMA Neurology, draws on records from US veterans treated by the Department of Neurology between 1999 and 2022. Data were adjusted for age, sex, race, smoking and other health factors.
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Veterans with untreated sleep apnea were nearly twice as likely to develop Parkinson’s as those without apnea, a study found. Over five years, this has translated into one to two additional cases of Parkinson’s per 1,000 people.
Early CPAP use was linked to 2.3 fewer cases of Parkinson’s disease per person – about one case prevented per 439 people treated for five years. (Stock)
Among veterans who started CPAP therapy early, the risk was nearly 30% lower.
That reduction amounts to approximately 2.3 fewer cases of Parkinson’s per person, meaning that early CPAP treatment could prevent one case for every 439 people treated over five years.
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“The best strategy for neurodegenerative disease is to prevent and catch risk factors early, before damage is done,” Scott said.
The investigators suggest that low oxygen, inflammation and disrupted brain processes may explain the link between sleep apnea and neurodegeneration. (Stock)
The investigators suggest several possible reasons for this link. Repeated drops in oxygen during sleep can damage neurons, increase inflammation and disrupt the brain’s ability to clear waste, allowing toxic proteins to accumulate.
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“If you stop breathing several times an hour and your oxygen levels drop … you’re actually shocking those brain cells every time that happens,” said Dr. Neurson, co-author of the study.
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By exercising oxygen and improving sleep continuity, scientists believe that CPAP may reduce those stresses and protect brain tissue in the long run.
Because the study was observational, it shows a connection, not evidence of contact. (Stock)
The study’s authors emphasize, however, that their findings merely indicate an association between sleep disorders and neurological disorders.
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Because this was an observational analysis, it cannot prove that sleep apnea causes Parkinson’s.
The group also lost detailed information on how participants used their CPAP devices. Also, most of the veterans in the study were older men, meaning the results may not generalize to other populations.
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In addition, the researchers note that the early symptoms of Parkinson’s, including sleep disturbances, may have led some people to be diagnosed with apnea in the first place.
