Common sleep problem linked to serious neurological disorder in major new study

A major new study has found a notable connection between untreated sleep apnea and an increased risk of Parkinson’s disease.

A team of researchers at Oregon Health and Science University (OHSU) studied more than 11 million veterans ages 40 and older who did not already have Parkinson’s disease.

Some of them had been diagnosed with obstructive sleep apnea, a condition in which breathing stops and starts repeatedly during sleep. The researchers then tracked who developed Parkinson’s for an average of nearly five years.

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They also examined veterans who started continuous positive airway pressure (CPAP) therapy within two years of their sleep apnea diagnosis, looking for any differences in Parkinson’s outcomes compared to those who delayed or never started CPAP.

Dr. Greg Scott, an Oregon pathologist and co-author of the study, called the findings “surprising” in a news release.

“People who still had Parkinson’s but had been using CPAP had fewer fractures, fewer falls and lower mortality. We tested this rigorously and the result continued to occur,” he said.

The research, published in JAMA Neurology, is based on records of American veterans who were treated through the Department of Veterans Affairs between 1999 and 2022. The data was adjusted for age, sex, race, smoking and other health factors.

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The study found that veterans with untreated sleep apnea were almost twice as likely to develop Parkinson’s as those without apnea. For about five years, this translated to about one or two additional cases of Parkinson’s per 1,000 people.

Among veterans who started CPAP therapy early, the risk was about 30 percent lower.

That reduction represented about 2.3 fewer cases of Parkinson’s per 1,000 people, meaning that early treatment with CPAP could prevent one case for every 439 people treated over five years.

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“The best strategy for a neurodegenerative disease is prevention and early detection of risk factors, before the damage is done,” Scott said.

The researchers propose several potential reasons for this link. Repeated drops in oxygen during sleep can damage neurons, increase inflammation, and interfere with the brain’s ability to eliminate waste, allowing toxic proteins to build up.

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“If you stop breathing several times an hour and your oxygen levels drop… you’re essentially stunning those brain cells every time that happens,” Dr. Lee Neilson, an OHSU neurologist and lead author of the study, said in the same news release.

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By stabilizing oxygen and improving sleep continuity, scientists believe CPAP can reduce that stress and protect brain tissue over time.

However, the study authors emphasized that their findings only show an association between sleep disorders and neurological diseases.

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Because this was an observational analysis, it cannot definitively prove that sleep apnea causes Parkinson’s.

The team also lacked detailed data on how consistently participants used their CPAP devices. Additionally, the majority of veterans in the study were older men, meaning the results may not be generalizable to other populations.

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Additionally, the researchers noted that early signs of Parkinson’s, including sleep disorders, could have led some people to be diagnosed with apnea in the first place.