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Front Aging Neurosci. 2016 Apr 12;8:78. doi: 10.3389/fnagi.2016.00078. eCollection 2016.

The Association Between Obstructive Sleep Apnea and Alzheimer's Disease: A Meta-Analysis Perspective.

Author information

1
Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS)Kermanshah, Iran; Department of Psychiatry, University of Social Welfare and Rehabilitation SciencesTehran, Iran.
2
Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS) Kermanshah, Iran.
3
Sleep Disorders Centre, Guy's and St Thomas' HospitalLondon, UK; Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience (IOPPN), King's College and Imperial CollegeLondon, UK.
4
Sleep Disorders Centre, Guy's and St Thomas' HospitalLondon, UK; Academic Unit of Sleep and Breathing, National Heart and Lung Institute, Imperial College and NIHR Respiratory Disease Biomedical Research Unit at the Royal Brompton and Harefield NHS Foundation Trust and Imperial CollegeLondon, UK.
5
Division of Neurology, Faculty of Medicine, University of British Columbia Vancouver, BC, Canada.

Abstract

Alzheimer's disease (AD) and obstructive sleep apnea (OSA) are highly prevalent, chronic conditions with intriguing, yet poorly understood epidemiological overlap. To date, the amount of OSA syndrome present in patients with AD across literature remains unknown. To address this question, we collected all available published clinical data and analyzed them through a quantitative meta-analytical approach. The results of our quantitative meta-analysis suggest that the aggregate odds ratio for OSA in AD vs. healthy control was 5.05 and homogeneous. This reflects that patients with AD have a five times higher chance of presenting with OSA than cognitively non-impaired individuals of similar age. Moreover, these data suggest that around half of patients with AD have experienced OSA at some point after their initial diagnosis. The additive impact of progressive changes in sleep quality and structure, changes in cerebral blood flow and the cellular redox status in OSA patients may all be contributing factors to cognitive decline and may further aggravate AD progression. It is hoped that the high OSA rate in AD patients, as suggested by the findings of our meta-analysis, might provide a sufficient clinical incentive to alert clinicians the importance of screening patients for OSA in AD, and stimulate further research in this area.

KEYWORDS:

Alzheimer’s disease; meta-analysis; obstructive sleep apnea; prevalence; sleep-disordered breathing

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