Study Links Sleep Apnea and Less Deep Sleep to Worse Brain Health

Nearly one billion people worldwide have sleep apnea¹, a disorder that can cause you to periodically stop breathing and experience micro-awakenings when you are sleeping. Medical professionals have long known that this disorder can lead to health complications²  such as poor sleep, strokes, heart attacks, problems with certain medications and general anesthesia, and glaucoma. 

However, new research is shedding light on another complication of this sleep disorder. The 2023 study³, from the American Academy of Neurology, has found that uncontrolled sleep apnea and less deep sleep as a result of sleep apnea can also worsen your brain health.

The study observed 140 participants from the Mayo Clinic Study of Aging. The average age for those in that study was 72 and the cases of mild, moderate, and severe sleep apnea were divided nearly equally among them. None of the participants had dementia, but they had all undergone magnetic resonance imagining (MRI) scans.³ 

These MRI scans were used to study their white matter damage, also referred to as white matter hyperintensities⁴. In addition to looking for hyperintensities, the researchers also evaluated the biomarker that measures the movement of water inside fibers that connect neurons to the brain.³ This was used to measure early-stage white matter abnormalities that are associated with vascular disease, which has been considered a leading cause of dementia⁵. 

When looking at this biomarker, the researchers factored out conditions associated with changes in the brain such as age, cholesterol levels, and blood pressure. The results showed that those who only had 5 percent of their total sleep happen during slow-wave sleep looked more than 4.5 years older when it came to white matter abnormalities than those who got 25 percent of their rest in deep sleep.³ 

It should be noted that the association between sleep apnea and hyperintensities was only shown in severe cases. This, according to the researchers, suggests that mild to moderate sleep apnea may not cause white matter abnormalities.³

This study suggests that a lack of slow-wave sleep caused by severe sleep apnea can have significant impacts on your brain health when compared to those who spend more time in deep sleep.³ 

Slow-wave sleep is when the body restores itself and boosts your energy and immunity⁶, but it is also when you rid yourself of beta-amyloid⁷, a marker for Alzheimer’s. Therefore, getting enough deep sleep is an essential step in flushing out beta-amyloid and reducing your risk of Alzheimer’s. 

Additionally, the study presented that those who had less deep sleep showed faster brain aging.³ This brain aging may cause a lag in your ability to process information⁸, along with other memory issues. 

While getting adequate deep sleep is important for helping to prevent dementias like Alzheimer’s, it’s also essential for boosting everyday brain health. For example, those who aren’t getting enough deep sleep are likely to have a harder time paying attention during the day, which can impact school or work performance, as well as the ability to safely drive or operate machinery. 

When white matter damage occurs due to lack of quality sleep (or other causes), healthcare providers focus on managing symptoms⁹ as this has been shown to slow the progression of white matter damage. These preventative steps to help control white matter damage can include⁹:

• Lifestyle and diet changes
• Regular exercise 
• Avoiding tobacco and alcohol

Considering we also know that sleep apnea and poor sleep quality are linked to high blood pressure, heart attacks, strokes, and more, it is essential to manage apnea symptoms and prioritize good sleep.²

• Weight Loss – Obstructive sleep apnea is most often seen in overweight or obese¹⁰ people because additional weight leads to fat deposits in the neck that can block your airway when you are sleeping. Therefore, weight loss could help alleviate symptoms.

• Continuous Positive Airway Pressure (CPAP) – If you have been diagnosed with sleep apnea after a polysomnography, your medical professional may prescribe a continuous positive airway pressure (CPAP) device. These machines provide continuous air pressure that reduces the number of times that you stop breathing from obstruction. CPAP therapy is available by prescription only.

• Oral Appliances – Those with mild or moderate sleep apnea may find that an oral device that keeps your throat open may help you get more deep sleep. These mouthpieces work by either bringing your lower jaw forward or by holding your tongue in a different position. A dentist will need to fit you for one of these.  

• Surgery – There are a variety of surgeries¹¹ that can help eliminate obstructions, including those that remove tissue from the back of the mouth and the top of the throat and ones that move the jaw forward. If other treatments and surgeries have failed and you have life-threatening sleep apnea, a surgeon may perform a tracheostomy, a procedure in which a surgeon makes an opening in the neck and inserts a tube that provides unobstructed air passage.¹¹ 

Tips for Getting More Deep Sleep