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Sleep Apnea: Beyond Snoring

A new brain imaging study from the University of California, Los Angeles School of Nursing shows the impact of obstructive sleep apnea on the structure of the brain.

The study also reveals noticeable differences in the brains of both men and women affected with the sleep disorder.

Obstructive sleep apnea is a condition caused by an obstruction of the airway during sleep. According to the American Sleep Apnea Association, 22 million Americans are affected by sleep apnea. Men are twice as likely to develop OSA than women.

The ASAA believes 80 percent of moderate and severe cases of sleep apnea in the United States are undiagnosed.

Untreated obstructive sleep apnea can lead to some serious health conditions including migraines, high blood pressure, cardiovascular disease and diabetes.

Obstructive sleep apnea can also lead to brain damage if patients do not seek treatment.

During the study, the UCLA researchers analyzed brain scans and health records of patients diagnosed with obstructive sleep apnea.

The study authors examined the high-resolution magnetic resonance imaging (MRI) scans to measure the cerebral cortex thickness of the 12 female and 36 male participants who had mild to severe obstructive sleep apnea but had not treated their condition.

The cerebral cortex is the outer layer of the cerebrum that composed of folded gray matter and plays a critical role in consciousness, memory, perception, cognition and awareness.

They compared these measurements to those of 22 female and 40 male individual who served as healthy controls without sleep apnea.

Their findings showed that cerebral cortex of those patients who had untreated sleep apnea was thinner than individuals without sleep apnea.

Additional findings revealed that obstructive sleep apnea affected the brains of men and women differently regarding brain structure and symptoms.

Women with obstructive sleep apnea had cortex thinning in their superior frontal lobe at higher rates than men with the condition, a discovery that may explain why women with sleep apnea have more significant cognitive problems that men with the condition.

None of the participants with sleep apnea showed signs of cerebral cortex thickening.

Additionally, cortex thinning may cause issues in patients related to the regulation of the autonomic nervous system. This disruption in the autonomic nervous system could cause sleep apnea sufferers’ upper-airway breathing dysfunction, a situation commonly seen in sleep apnea patients.

While previous studies have connected changes in brain structure and sleep apnea, the UCLA research is the first to link symptoms and brain structure differences in brain structure with apnea symptoms.

What the research has not yet uncovered is if the changes in the brain’s structure occur before the patient develops sleep apnea, or if sleep apnea causes the symptoms to worsen as the condition develops.

The research may lead to new, gender-specific treatments for individuals with sleep apnea. The study also brings further attention to the seriousness of sleep apnea.

“A lot of people think that sleep apnea is just about snoring. They do not realize the condition has life-threatening health implications,” said Dr. Stefania Caracioni.

Caracioni treats patients with sleep apnea in her Topeka dental practice.

“Patients living with sleep apnea are at a greater risk of stroke and heart attack,” Caracioni said.

Conventional treatments for sleep apnea include a CPAP machine, designed to force open the throat and allow patients to breathe easier. However, this treatment is not ideal for everyone.

“CPAP machine can be noisy and make patients feel claustrophobic. They can also cause dry mouth conditions that can lead to oral health problems, too,” Caracioni.

To treat sleep apnea sufferers, Caracioni uses a custom-fitted oral appliance that shifts the position of the jaw forward to prevent the tongue from falling back and blocking the airway.

“Many individuals with sleep apnea have an obstruction that occurs when the jaw is out of position and too far back. When the patient relaxes during sleep, their tongue relaxes and falls back, blocking the throat,” Caracioni said.


American Sleep Apnea Association. Sleep Apnea Information for Clinicians. 2017.

Psych Central. Gender Differences Found in Brains of Sleep Apnea Patients.. 4 April 2018.

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