Sleep Apnea

  • Sleep Apnea, Sleep Health

    Sleep apnea associated with 50% higher risk of memory problems.

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    Original Article | Medical News Today

    • A new study analyzes the impact of sleep apnea symptoms on memory and thinking.
    • Sleep apnea is a sleep disorder that sometimes causes people to stop breathing.
    • The study subjects participated in a survey where they reported any symptoms of sleep apnea and difficulty with remembering things.
    • The study shows an association between sleep apnea symptoms and a higher rate of memory and thinking problems.

    Getting a good night’s sleep is important for many reasons, from having the energy to go about one’s daily tasks to optimal brain performance.

    Sleep apnea can interfere with this, and according to the National Council on Aging, it may impact around 39 million adults in the United States.

    While experts know sleep apnea can impact quality of life and even contribute to mood disordersTrusted Source, there is still more to learn.

    A researcher based in Boston recently conducted a cross-sectional study to determine whether a correlation between sleep apnea and thinking and memory problems exists.

    The findings showed that having sleep apnea symptoms correlated with a 50% increase in memory and thinking problems.

    The researcher will present the findings at the American Academy of Neurology’s Annual Meeting in April 2024. The research hasn’t yet been published in a peer-reviewed journal.

    Sleep apnea linked to thinking and memory issues

    Most people with sleep apnea have obstructive sleep apnea (OSA), but some experts have said that OSA is underdiagnosed.

    For instance, researchersTrusted Source note, “it is believed that more than 85% of patients with clinically significant OSA have never been diagnosed.”

    With the notion that sleep apnea could be underdiagnosed in mind, researcher Dr. Dominique Low wanted to learn more about a possible connection between sleep apnea and cognition. Dr. Low works at Boston Medical Center in Massachusetts and is a member of the American Academy of Neurology.

    Dr. Low pulled data from a government-funded survey called the 2017–18 National Health and Nutrition Examination Survey (NHANES) to establish a potential link between sleep apnea and thinking and memory.

    The study participants included 4,257 adults ages 20 and older. Of the questionnaires they completed for the NHANES, they answered questions about sleep quality, memory, and thinking.

    Dr. Low used the data from these questionnaires to determine how people who reported sleep apnea symptoms compared to people without these symptoms.

    The participants also answered questions on their memory quality, whether they had any periods of confusion, and if the participants thought they had trouble making decisions.

    A total of 1,079 participants reported sleep apnea symptoms, including snoring and gasping for breath while asleep.

    Of people who indicated they had sleep apnea symptoms, 33% also reported symptoms of memory and thinking problems. This is significantly higher than the number of people without sleep apnea symptoms who reported such problems, which was only 20% of that group.

    After adjusting for other factors like age, race, and gender, Dr. Low observed that people with sleep apnea symptoms had a 50% higher chance of having thinking and memory issues compared to participants who didn’t report sleep apnea symptoms.

    “Our study found participants who had sleep apnea symptoms had greater odds of having memory or thinking problems,” Dr. Low said in a news release. “These findings highlight the importance of early screening for sleep apnea.”

    Despite the implications of these findings, it’s important to note that a correlation does not indicate causation. Scientists must conduct further research that does not rely solely on self-reported symptoms to establish the effects of sleep apnea symptoms on memory and thinking.

    Reducing the risk of cognitive decline

    Dr. Joey R. Gee, a neurologist at Providence Mission Hospital in Mission Viejo, California, spoke with Medical News Today about how sleep apnea may impact memory. Dr. Gee was not involved with the study.

    “Apnea may have an impact due to poor oxygenation through the night or also impairing appropriate sleep cycles with frequent arousals,” Dr. Gee noted. “Impaired executive functions, such as working memory and attention through the day, are greatly impacted.”

    Dr. Gee said that while untreated sleep apnea may impact cognitive function, the risk could be reduced with appropriate treatment.

    “Just as untreated sleep apnea increases the risk of impairment in executive function and attention, treatment can substantially reduce the risk of progressing cognitive decline,” Dr. Gee said.

    Dr. Thomas Kilkenny, the director of the Institute of Sleep Medicine at Staten Island University Hospital in New York, not involved in the study, emphasized the importance of treating sleep apnea as soon as it is detected.

    “If the patient can be treated early in OSA, these brain damages will not occur,” Dr. Kilkenny told MNT. “There will be a decrease in the amount of cognitive decline in OSA patients.”

    Dr. David Merrill, a geriatric psychiatrist and director of the Pacific Neuroscience Institute’s Pacific Brain Health Center at Providence Saint John’s Health Center in Santa Monica, California, not involved with the study, shared his thoughts on the findings with MNT:

    “With high quality, restorative sleep, the brain’s function is enhanced and protected as we age,” explained Dr. Merrill. “If sleep is chronically disrupted, this can lead to a number of health issues, including headaches, fatigue, and memory loss that worsens over time. The disrupted, poor-quality sleep seen in sleep disorders leads to both acute and chronically worsening changes in the brain. Normally, a good night’s sleep literally allows for repair and restoration of brain function to the levels seen at the beginning of the prior day.”

    Dr. Merrill also spoke about the importance of treating sleep apnea and noted that it is a risk factor for developing dementia. While that may sound scary, he said that using a CPAP machine can help reduce risk.

    “Research studiesTrusted Source have shown that even 4 hours per night using a CPAP device results in significantly less worsening of cognitive decline over time,” said Dr. Merrill.

    What to know about sleep apnea

    Sleep apnea, including obstructive sleep apnea and central sleep apnea, can affect people of all ages but, as the National Council on Aging notes (link above), it is most prevalent in middle-aged and older adults.

    Some symptomsTrusted Source of sleep apnea a person may detect on their own include:

    • sleepiness during the day
    • headaches
    • difficulty focusing

    A person’s partner may notice additional symptoms such as snoring or gasping for breath while asleep.

    “Signs of obstructive sleep apnea are usually readily apparent,” Dr. Kilkenny said.

    “Loud snoring, restlessness, and daytime fatigue are the hallmarks of OSA,” he noted. “If someone snores even to a minor degree, they should bring this to the attention of their physician so they can get tested for OSA before damage occurs.”

    People with sleep apnea can treat it using a continuous positive airway pressure (CPAP) machine.

    They may also try to improve symptoms by making lifestyle changes such as losing weight. They may also have surgery or use an oral appliance.

  • Sleep Apnea, Sleep Health, Sleep Study

    Recent studies show how a migraine can be predicted.

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    Sleep quality and energy levels are two of the biggest indicators of an impending migraine attack, the study showed. Get inspired by a weekly roundup on living well, made simple.  

    Wouldn’t it be helpful to have a sense of when a debilitating migraine may be on the way?

    You may be able to do so, a new study has shown.

    Migraine

    “The major finding from this study was that changes in sleep quality and energy on the prior day were related to incident headache in the next day,” said Dr. Kathleen Merikangas, principal investigator of the study that published Wednesday in the journal Neurology.

    Migraines are nothing to shake your head at, and they certainly aren’t just nuisance headaches. Chronic migraines are the leading cause of disability in people younger than 50, according to a February 2018 study.

    More symptoms than you think may be tied to your migraines

    The study team found that sleep quality and energy were important indicators of a migraine attack on the following day.

    Those who had bad sleep quality and low energy one day were more likely to have migraines the next morning, the data showed. An increase in energy and greater-than-average stress usually foretold a migraine would appear later the next day.

    “It’s a very exciting study because of how well done and how detailed and how large it is,” said Dr. Stewart Tepper, vice president of the New England Institute for Neurology and Headache in Stamford, Connecticut. Tepper was not involved in the research.

    The differences point to the importance of your circadian rhythm — which regulates your cycles of sleep and wakefulness — in how headaches manifest. The findings may inform the treatment and prevention of migraine attacks.

    Migraine prevention

    Knowing when a migraine is coming can make all the difference — especially with growing interest in treating one before it starts, Tepper said.

    “If we can identify things in the environment that people can change, then we’d like to be able to prevent the attack in the first place,” Merikangas said. “If we can do that with behavioral interventions … then they may be able to prevent it by either going to sleep to offset it or some other intervention that would prevent us from having to use medication to prevent the attack.”

    Tepper, however, said he is not so sure if changes in behavior can always prevent a migraine attack.

    FDA approves new nasal spray to treat migraine headaches in adults, Pfizer says

    A migraine attack isn’t just a headache. And warning signs such as fatigue, neck pain and sleep disturbance may be early symptoms of an attack — not only a trigger of one, he added.

    Instead, Tepper advises intervening with medication before the head pain starts in hopes of warding off any pain at all.

    How much is too much?

    It makes sense that people might be conservative about using medication for migraine pain, Tepper said.

    An older class of medications, called triptans, was associated with more migraines and a resulting chronic migraine condition if used more than 10 days in a month, he said.

    But a newer option, rimegepant — sold as Nurtec — doesn’t seem to carry the same risk.

    “There’s no downside because rimegepant has almost no side effects and is not associated with transformation into chronic migraine,” Tepper said.

    What you can do about migraines

    Your doctor can recommend pain medication to address your migraines, but it also helps to know the signs of an upcoming attack, Tepper said.

    As well as monitoring sleep, exercise and diet, Merikangas suggests finding a way to monitor stress to be able to track the indicators of a migraine.

    There are five typical signs of an oncoming migraine headache, Tepper said. Those are sensitivity to light, fatigue, neck pain, and sensitivity to noise and dizziness, he said.

    5 ways to reduce your stress this year

    Cognitive behavioral therapy is often useful to help manage the stress that can trigger migraine attacks. What’s more, taking vitamins and supplements, such as magnesium and riboflavin, can be effective in reducing migraine frequency, Kylie Petrarca, a nurse and education program director at the Association of Migraine Disorders, said in a previous CNN article.

    It isn’t just about avoiding the pain, Merikangas said.

    “It’s really important to think of the full context of our health,” she said. “By being able to characterize not just headaches, but also all these other systems, we might be able then to get a handle on causes of negative health events.”

  • Sleep Apnea, Sleep Health

    Why people should prioritize sleep quality over quantity.

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    By Analisa Novak – February 19, 2024 / 11:59 AM EST / CBS News

    When it comes to maintaining heart health, it’s not just how long you sleep — it’s how well you sleep that matters equally, if not more, said Dr. Shelby Harris, a behavioral sleep psychologist and clinical associate professor at Albert Einstein College of Medicine.

    “Poor quality sleep really can influence our heart health as well,” Harris told “CBS Mornings” in an interview during American Heart Month. 

    Harris said the body’s balance of ghrelin and leptin, hormones that regulate hunger, is also disrupted by poor sleep, leading to increased consumption of high-sugar and high-fat foods. 

    Sleep disorders like sleep apnea and insomnia are closely linked to heart health. Sleep apnea, characterized by snoring and breathing pauses, affects both men and women, though women are evaluated less frequently for it. 

    Strategies for improving sleep quality include limiting alcohol and caffeine intake, reducing screen time before bed and managing how much liquid you drink before bed. 

    “Once you have better quality then we try to work on the quantity of sleep possible,” Harris said.

    For those struggling to achieve a longer sleep duration, getting a good quality amount of sleep but shorter is ideal when you first are trying to tackle this goal. 

    “For some people, I might have them go to bed later and then I might slowly have them go to bed earlier over time as opposed to that shifting back and forth. Because that can create a lot of problems for people as well,” she said. 

    Harris said that sleeping pills and aids are not ideal for most people, but said cognitive-behavioral therapy for insomnia may offer an alternative solution to medication. 

    She said most people try four to eight sessions of the therapy and if that doesn’t work, then she would recommend sleeping aids. 

    “You work on not just the hygiene but you work on the timing of sleep. … We work on thoughts about sleep, a lot of people put pressure on themselves to sleep and they worry about what’s going to happen if they don’t sleep and so we work on that aspect,” she said. 

    Harris said dietary choices also play a role in a good night’s sleep. She said people should avoid consuming large or heavy meals, such as a big dinner, before going to bed.

    Instead, opting for a small, light snack that includes a mix of protein and carbohydrates can be beneficial. “That’s a really good mix to help you throughout the night so you don’t wake up hungry, which a lot of people do as well,” said Harris.

  • Sleep Apnea, Sleep Apnea Dentist

    Can obstructive sleep apnea negatively impact brain health?

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    Original Article | Medical News Today

    • Obstructive sleep apnea, the most common type of sleep breathing disorder, is a risk factorTrusted Source for cerebrovascular disease, conditions that affect blood vessels in the brain.
    • Obstructive sleep apnea is also linkedTrusted Source to mild cognitive impairment and Alzheimer’s disease, but the mechanisms underlying this association are not well understood.
    • Dementia is also associated with abnormalities in the brain’s white matter that are hallmarks or markers of cerebrovascular diseases.
    • A recent observational study shows that severe obstructive sleep apnea and reduced deep sleep were independently associated with white matter abnormalities related to cerebrovascular diseases in cognitively unimpaired older adults.
    • These findings show that severe obstructive sleep apnea and poor sleep quality can lead to an increase in the biomarkers of cerebrovascular disease, potentially increasing the risk of cognitive decline and stroke.

    Obstructive sleep apnea is the most common type of sleep-breathing disorder that affects nearly a billionTrusted Source individuals across the globe.

    A recent study published in Neurology suggests that obstructive sleep apnea and a reduction in deep sleep, also known as slow-wave sleep, were independently associated with an increase in white matter abnormalities in the brain.

    The white matter abnormalities assessed in the study are known markers of cerebrovascular disease and are also observed in mild cognitive impairment and Alzheimer’s disease.

    The findings from this observational study thus suggest that obstructive sleep apnea and poor sleep quality could potentially lead to increased white matter abnormalities, subsequently increasing the risk of dementia and stroke.

    The study’s author Dr. Diego Carvalho, a neurologist at the Mayo Clinic in Rochester, MN, told Medical News Today:

    “White matter abnormalities increase with aging and may contribute to cognitive decline, dementia, and stroke. Since there is no treatment to reverse or slow them down other than risk factor prevention, it is important to understand what may contribute to their development.”

    “In our study, we found that severe sleep apnea and decreased deep sleep were associated with more white matter abnormalities. Although we cannot infer a direct causal relationship with a cross-sectional study design, the findings raise the possibility that sleep interventions may prevent the progression of white matter disease. Although there is already compelling evidence that sleep apnea is involved in white matter abnormalities, the potential role of slow-wave sleep (or deep sleep) in white matter health is much less understood,” added Dr. Carvalho.

    Sleep quality and dementia

    Obstructive sleep apneaTrusted Source is a sleep-breathing disorder characterized by episodes of interruption of breathing due to partial or complete blockage of the upper airway. The episodes of reduced breathing are known as hypopnea, whereas apnea refers to events involving a complete blockage of the upper airway.

    The apnea-hypopnea index (AHI) describes the number of apnea and hypopnea events per hour. Specifically, obstructive sleep apnea involves at least five such episodes of apnea or hypopnea per hour.

    The interruption of breathing triggers a compensatory response that leads to arousal from sleep. Thus, obstructive sleep apnea leads to sleep disturbances and an experience of feeling unrefreshed after sleep.

    Several studies have shown that poor sleep quality is associated with an increased risk of cognitive decline and dementia.

    The accumulation of misfolded deposits of the amyloid-beta and tau proteins is a hallmark of Alzheimer’s disease. A previous study showed a higher accumulation of the amyloid-beta protein in the brains of individuals experiencing excessive daytime sleepiness.

    In contrast, a brain imaging studyTrusted Source showed that cognitively unimpaired individuals with higher tau levels in their brains were at an increased risk of obstructive sleep apnea.

    These studies suggest a bidirectional relationship between sleep quality and pathological changes associated with Alzheimer’s disease.

    Why white matter changes have an impact

    In addition to the accumulation of misfolded proteins, individuals with dementia also show damage to neurons.

    The brain tissue can be categorized into white matter and gray matter. The gray matter consists of the cell bodies of neurons, whereas the white matter consists of axons that transmit information.

    Several of the axonal processes in the white matter are encased in an insulating layer called the myelin sheath. The myelin sheath gives white matter its color and allows the axons to conduct electrical impulses more rapidly and efficiently.

    Individuals with dementia and mild cognitive impairment show abnormalities in the white matter. Some of these white matter abnormalities, such as white matter hyperintensitiesTrusted Source and a decline in the integrity of the white matter tract, are also markers for cerebrovascular diseases, which are diseases of the blood vessels in the brain.

    White matter hyperintensities are hyperintense regions identified using MRI that represent lesions of white matter generally caused by cerebral small vessel disease.

    The integrity of the white matter tract is measured in terms of fractional anisotropy using a technique called diffusion tensor imaging. These white matter abnormalities due to damage to blood vessels may contribute to cognitive decline.

    Sleep and cerebrovascular health

    Sleep disorders such as obstructive sleep apnea are also associatedTrusted Source with increased risk of cerebrovascular diseases. Thus, sleep disorders could potentially lead to cerebrovascular disease-related white matter abnormalities and increase the risk of dementia.

    For instance, there is evidence from the authors’ own work showing that individuals with daytime sleepiness have elevated levels of the neurofilament light chain protein in their blood, though research evidence is contradictoryTrusted Source.

    The neurofilament light chain protein is a protein associated with the myelin sheath covering the axons of neurons. Thus, elevated neurofilament light chain protein levels suggest damage to myelinated axons and, thus, white matter damage.

    In the present study, the researchers examined the association between sleep quality, including the presence of obstructive sleep apnea, with white matter abnormalities in the brain of cognitively unimpaired individuals.

    A study on sleep and cognitive impairment

    The new study consisted of 140 individuals participating in the Mayo Clinic Study of Aging (MCSA), a population-based cohort study that aims to characterize the prevalence and risk factors associated with mild cognitive impairment and dementia.

    The study included individuals who had previously undergone a brain MRI scan and at least one polysomnography test as a part of the MCSA study.

    A polysomnographic study is a sleep study that assesses multiple parameters associated with sleep, including brain waves, breathing and heart rate, and blood oxygen levels. The average duration between the brain MRI scan and the polysomnography test was 1.74 years.

    The researchers aimed to only include participants who were cognitively unimpaired at the time of both the MRI and the polysomnography test. The study consisted of 90.7% of the participants who were cognitively unimpaired at the time of both assessments.

    Only participants with obstructive sleep apnea were included in the study. These participants were categorized as having either mild, moderate, or severe obstructive sleep apnea on the basis of the number of episodes of apnea and hypopnea per hour.

    Sleep quality and cerebrovascular biomarkers

    The researchers first examined the association between sleep patterns and white matter abnormalities. Sleep can be dividedTrusted Source into the non-rapid eye movement (NREM) and rapid eye movement (REM) phases.

    Furthermore, the NREM phase can be further subdivided into N1-N3 phases, with the N1 being the lightest sleep phase and N3 involving deep sleep. These phases show differences in their patterns of brain waves, eye movements, and muscle tone.

    Using brain waves collected during polysomnography, the researchers found that a lower fraction of time spent in the N3 phase or slow wave sleep was associated with elevated levels of white matter damage.

    This association was present after accounting for variables such as age, sex, genetic risk of Alzheimer’s disease, and cardiovascular risk factors.

    In a separate analysis, the researchers looked at the association between obstructive sleep apnea severity and markers of white matter damage. They categorized patients as either having severe or mild-to-moderate obstructive sleep apnea and matched individuals from the two groups for age, sex, and N3 sleep levels for this analysis.

    Individuals with severe obstructive sleep apnea showed higher white matter abnormalities than those with mild-to-moderate.

    Individuals in the two groups did not show differences in cardiometabolic risk factors, but the individuals with severe obstructive sleep apnea showed higher arousal levels. This indicates the fragmentation of sleep in individuals with severe obstructive sleep apnea.

    Dr. Sandra Narayanan, a board-certified vascular neurologist and neuro-interventional surgeon at Pacific Stroke & Neurovascular Center at Pacific Neuroscience Institute in Santa Monica, CA, not involved in the research told us that these findings show that, while obstructive sleep apnea is associated with cardiovascular disease, it could independently increase the risk of cerebrovascular diseases.

    Dr. Narayanan said: “[Obstructive sleep apnea] is an important vascular comorbidity, as it is significantly associated with an increased risk of hypertension, cardiovascular disease, and stroke. This study demonstrates a separate association of OSA with imaging biomarkers of cerebrovascular disease.”

    Strengths and limitations

    Some of the previous studies showing a link between sleep quality and white matter abnormalities have not controlled for cardiometabolic risk factors. These cardiometabolic factors can increase the risk of cerebrovascular conditions, such as stroke, thus potentially biasing the results.

    One of the strengths of the present study was that the researchers controlled for cardiometabolic risk factors.

    The authors acknowledged that their study had a few limitations. They noted that they only collected sleep data during the initial few hours of sleep.

    This could have biased the data on sleep patterns. For instance, the period of REM sleep tends to increase during the night, whereas the duration of deep sleep tends to decline.

    Dr. Narayanan noted: “While the imaging biomarkers of CVD noted in this study were not independently linked during the course of this study to the development of incident stroke, the presence of white matter hyperintensities is strongly associated with cognitive impairment, stroke, and death in numerous other studies.”

    “Fractional anisotropy (FA) is a marker of white matter integrity, as noted in diffusion tensor imaging (DTI),“ she explained. “Decreased FA is associated with other neurodegenerative disorders such as Alzheimer’s dementia and Parkinson’s disease, but has a poor prognostic value for motor recovery following stroke.”

    The authors also noted that the study had an observational design, and further studies are needed to show that obstructive sleep apnea and reduced slow-wave sleep can cause an increase in the biomarker of cerebrovascular disease.

  • Sleep Apnea, Sleep Apnea Dentist, Sleep Health

    Five Weird Signs of Sleep Apnea

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    Original Article | By Sandee Lamotte CNN

    Sign up for CNN’s Sleep, But Better newsletter series. Our seven-part guide has helpful hints to achieve better sleep.CNN — 

    If you snore the house down, you may be suffering from obstructive sleep apnea, or OSA — a potentially dangerous condition in which people stop breathing for 10 seconds or more at a time.

    The condition has been linked to smaller brain volume, damage to the white matter communication pathway in the brain and even a three times higher risk of dying from any cause. If left untreated, obstructive sleep apnea puts you at higher risk for hypertension, heart disease, type 2 diabetes, depression and even an early death, according to the American Academy of Sleep Medicine.

    Yet even if you’re a rock star at snoring, you may not know you have obstructive sleep apnea unless someone tells you about your nocturnal roars. That’s why it’s important for partners and friends to speak up and encourage snorers to get professional help.

    But what if you have an odd or quirky symptom besides snoring? You and your loved ones may have no idea that you are in danger, and the condition could go undiagnosed for years.

    “Greater than 30 million people have sleep apnea in the United States, yet it’s often underdiagnosed or misdiagnosed,” said sleep specialist and pulmonologist Dr. Raj Dasgupta, an associate professor of clinical medicine at the University of Southern California’s Keck School of Medicine.

    “It’s really misdiagnosed in women versus men because women may not present with the classic, heroic snoring that men often show,” he said.

    Here are five weird signs of obstructive sleep apnea to watch for, according to Dasgupta.

    Headache as a result of sleep apnea

    Night sweats

    There are many reasons people may sweat at night. It could be too hot, especially with the persistent heat waves in the past few years due to the climate crisis. Certain medications can cause night sweats, as can cancer, thyroid issues, the flu and bacterial infections, and the onset of menopausal symptoms, according to the Mayo Clinic.

    But research has shown that about 30% of people with obstructive sleep apnea have reported night sweats, Dasgupta said.

    “It’s because your body isn’t getting enough oxygen you fall into this sympathetic fight-or-flight mode, which triggers night sweats,” he said. “The research showed people with OSA that had night sweats were also more likely to have really low oxygen levels on top of having obstructive sleep apnea.”

    Sleep apnea can cause you to wake up tired, have difficulty regulating emotions and suffer from brain fog, experts say.

    Frequent awakenings

    Many people get up at night to empty their bladders — it can be caused by alcohol overindulgence, diabetes, edema, high blood pressure, certain medications, pregnancy, prostate issues and even drinking too many fluids before bed, according to the Cleveland Clinic.

    But getting up at least two times a night to urinate — which is called nocturia — can also be a sign of obstructive sleep apnea, Dasgupta said.

    “One study found about 50% of patients with OSA had nocturia, and they noted that treatment for the sleep disorder did cut back on awakenings,” he said.

    Nevertheless, frequent nighttime urination is not commonly asked about in screening questionnaires on sleep apnea in primary provider offices, Dasgupta said.

    Teeth grinding

    Grinding or clenching teeth while sleeping is called bruxism, and it too may be a sign of obstructive sleep apnea, Dasgupta said.

    “Certainly, anxiety and other factors can cause bruxism, but a common cause is obstructive sleep apnea,” he said. “There’s a theory on why — the airway becomes obstructed, so the muscles in the mouth and jaw move to try to free the blocked airway. That’s not been proven, but it is an interesting hypothesis.”

    Most people who grind or clench their teeth use a mouthguard suggested by their dentist for protection, but it won’t protect the jaw, Dasgupta said.

    “So, a person might also develop TMJ (dysfunction), which is pain in the temporomandibular joint, and that may also lead to other issues, such as headaches,” he said.

    Morning headaches

    Studies have found a link between having obstructive sleep apnea and waking up with a headache, Dasgupta said.

    “They typically occur daily or most days of the week and may last for several hours after awakening in the morning,” he said. “The cause of the headaches is not well-established and may be multifactorial.”

    Headaches caused by obstructive sleep apnea don’t appear to lead to nausea or increased sensitivity to light and sound. Instead, they seem to be a pressing sensation on both sides of the forehead that lasts about 30 minutes, according to a June 2015 study.

    Depression, fatigue and insomnia

    Some symptoms of obstructive sleep apnea can disguise themselves as issues of mental health, brain fog or other sleep problems, Dasgupta said.

    “Sleep affects our ability to think, react, remember and solve problems,” he said. “Women especially have a tendency to underreport atypical symptoms such as insomnia, fatigue and depression.”

    If obstructive sleep apnea awakens you, it may be hard to go back to sleep. A person may suspect insomnia, not realizing that a different issue may be triggering the awakenings.

    Symptoms of daytime fatigue include a lack of motivation to accomplish everyday tasks, a lack of productivity at work, memory problems and a low interest in being social, Dasgupta said. Those are also signs of depression, so if the sleep issues aren’t brought up at a health visit, the underlying cause may be missed.

  • Sleep Apnea

    New research finds deep-sleep brain waves predict blood sugar control

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    Original Article | Berkley News

    Researchers have known that a lack of quality sleep can increase a person’s risk of diabetes. What has remained a mystery, however, is why.

    Now, new findings from a team of sleep scientists at the University of California, Berkeley, are closer to an answer. The researchers have uncovered a potential mechanism in humans that explains how and why deep-sleep brain waves at night are able to regulate the body’s sensitivity to insulin, which in turn improves blood sugar control the next day. 

    “These synchronized brain waves act like a finger that flicks the first domino to start an associated chain reaction from the brain, down to the heart, and then out to alter the body’s regulation of blood sugar,” said Matthew Walker, a UC Berkeley professor of neuroscience and psychology and senior author of the new study. “In particular, the combination of two brain waves, called sleep spindles and slow waves, predict an increase in the body’s sensitivity to the hormone called insulin, which consequentially and beneficially lowers blood glucose levels.” 

    The researchers say this is an exciting advance because sleep is a modifiable lifestyle factor that could now be used as part of a therapeutic and painless adjunct treatment for those with high blood sugar or Type 2 diabetes.

    Scientists also noted an additional benefit besides the potential new mechanistic pathway. 

    “Beyond revealing a new mechanism, our results also show that these deep-sleep brain waves could be used as a sensitive marker of someone’s next-day blood sugar levels, more so than traditional sleep metrics,” said Vyoma D. Shah, a researcher at Walker’s Center for Human Sleep Science and co-author of the study. “Adding to the therapeutic relevance of this new discovery, the findings also suggest a novel, non-invasive tool — deep-sleep brain waves — for mapping and predicting someone’s blood sugar control.”

    The team’s findings were published today in the journal Cell Reports Medicine. 

    For years, researchers have studied how the coupling of non-rapid eye movement sleep spindles and deep, slow brain waves corresponded to an entirely different function — that of learning and memory. Indeed, the same team of UC Berkeley researchers previously found that deep-sleep brain waves improved the ability of the hippocampus — the part of the brain associated with learning — to retain information.

    Researchers have uncovered a potential mechanism in humans that explains how and why deep-sleep brain waves at night are able to regulate the body’s sensitivity to insulin, which in turn improves blood sugar control the next day. (Illustration courtesy Matthew Walker)

    But this new research builds on a 2021 rodent study and reveals a novel and previously unrecognized role for these combined brain waves in humans when it comes to the critical bodily function of blood sugar management. 

    The UC Berkeley researchers first examined sleep data in a group of 600 individuals. They found that this particular coupled set of deep-sleep brain waves predicted next-day glucose control, even after controlling for other factors such as age, gender and the duration and quality of sleep. 

    “This particular coupling of deep-sleep brain waves was more predictive of glucose than an individual’s sleep duration or sleep efficiency,” said Raphael Vallat, a UC Berkeley postdoctoral fellow and co-author of the study. “That indicates there is something uniquely special about the electrophysiological quality and coordinated ballet of these brain oscillations during deep sleep.”

    Next, the team then set out to explore the descending pathway that might explain the connection between these deep-sleep brain waves sending a signal down into the body, ultimately predicting the regulation of blood glucose. 

    The findings from the team reveal an unfolding set of steps that could help explain how and why these deep-sleep brain waves are related to superior blood sugar control. First, they found that stronger and more frequent coupling of the deep-sleep brain waves predicted a switch in the body’s nervous system state into the more quiescent and calming branch, called the parasympathetic nervous system. They measured that change in the body and the shift to this low-stress state using heart rate variability as a proxy. 

    Next, the team turned its attention to the final step of blood sugar balance. 

    The researchers further discovered that this deep sleep switch to the calming branch of the nervous system further predicted an increased sensitivity of the body to the glucose-regulating hormone called insulin, which instructs cells to absorb glucose from the bloodstream, preventing a deleterious blood sugar spike.

    That’s particularly important for people trying to back away from hyperglycemia and Type 2 diabetes.

    “In the electrical static of sleep at night, there is a series of connected associations, such that deep-sleep brain waves telegraph a recalibration and calming of your nervous system the following day,” Walker said. “This rather marvelous associated soothing effect on your nervous system is then associated with a reboot of your body’s sensitivity to insulin, resulting in a more effective control of blood sugar the next day.” 

    The researchers subsequently replicated the same effects by examining a separate group of 1,900 participants.

    “Once we replicated the findings in a different cohort, I think we actually started to feel more confident in the results ourselves,” Walker said. “But I’ll wait for others to replicate it before I truly start believing, such is my British skepticism.”

    The scientists said the research is particularly exciting given the potential clinical significance years down the line. Diabetes treatments already on the market can sometimes be difficult for patients to adhere to. The same is true of the recommended lifestyle changes, including different eating habits and regular exercise.

    Sleep, however, is a largely painless experience for most people. 

    And while sleep is not going to be the single magic bullet, the prospect of new technologies that can safely alter brain waves during deep sleep that this new research has uncovered may help people better manage their blood sugar. That, the research team said, is reason for hope.