Sleep Apnea and Brain Damage

[Geoffrey]

It has been said that sleep apnea, if left untreated, very well can lead to brain damage, as in the loss of both gray and white matter alike. From what my understanding is the gray matter is recoverable after 3 months’ CPAP therapy and the white after a year’s therapy, meaning memory loss could well be restored.

[PaulaO2]

Eh, my bet is it would depend on what else on the person has also been damaged due to untreated sleep apnea. The brain can easily be overwhelmed and decide that memory is less of a priority than, say, working to produce chemicals to keep the heart going or whatever.

[Geoffrey]

Paul aO2, thank you for the input. Let us hope so, you and I. I surely have some memory problems as of yet, and, more specifically, with my verbal memory.

[mesenteria]

Once memory is lost, it cannot be recovered....IF...it's related to the destruction of the synapses associated with the memory.  It is the physical aspect that is of concern when we notice shrinkage of tissue.  While the brain may regenerate regions that have suffered loss, it won't also recover the memories; they are lost.

All systems sufferer with repeated exposure to desaturations of oxygen, and to the accompanying rise in stress hormones meant to get us out of a jam quickly.  When our levels of serum cortisol remain elevated for prolonged exposure, it begins to harm us.  Our hearts suffer unduly when we stress them.  They're the workingest muscles in our bodies, and while they will respond to short-term emergency-type stress responses, they don't like being pressured for weeks, months, and years with elevated demands.  Apnea leads to heart arrhythmias, as you must already realize.  At least, many diagnosed heart arrhythmias are ultimately traced to one's apnea.  Happened to me.

Rest is restorative.  If it helps our bodies to recover, it stands to reason that it's also good for our brains.  That's probably why we know that sleep has stages that are marked by quite disparate brain waves.  When we go without sleep, everything starts to go wrong, but especially our judgement and cognitive processes, and not least is our attention to worldly cues.  Think missing a red light and driving through it.  Or swinging the boom and shovel without checking over to the side first.  Or forgetting to heed a well-intentioned reminder to not miss an important meeting.  Even more stress, except that we experience a constant diminishment of our ability to rebound or to cope.  It's a downhill slide.

A good sleep will help us to remember more, more easily, and to be able to use the memories and learning later due to its recovery.  There is such a thing as 'learning ability'.  We all have a certain 'speed' in learning, some faster than others.  If we're in a sleep deficit, or under stress, the result will be a severe degradation in memory-making and in learning.

One last observation: if this is all the case, it makes it clearer to me that I should be most active in my own recovery, monitoring, and use of effective health regimens and protocols if I want to tilt the inevitable slope related to aging in favour of a few more years of 'quality time'.  Apnea is a complicated subject, and how better to learn about it, to master it, than by ensuring our PAP therapy is effective?

[WillSleep]

It has been said that sleep apnea, if left untreated, very well can lead to brain damage, as in the loss of both gray and white matter alike. From what my understanding is the gray matter is recoverable after 3 months’ CPAP therapy and the white after a year’s therapy, meaning memory loss could well be restored.

Hi Geoffrey, 

I have not studied this topic and therefore have no opinion.  


If you are referencing a specific source it would be interesting to see it. 



Just an FYI..  If you have not yet looked.  

I did a quick search of PubMed  https://www.ncbi.nlm.nih.gov/pmc/?term=Gray+White+matter+Brain+Apnea

The top level articles below are all cited by other articles in PubMed and therefore MIGHT at least some level of credibility and are linked to similar articles.  


WillSleep 


Associations between Brain White Matter Integrity and Disease Severity in Obstructive Sleep Apnea
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4990476/

White Matter Damage and Systemic Inflammation in Obstructive Sleep Apnea
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4335530/ 

Sex Differences in White Matter Alterations Accompanying Obstructive Sleep Apnea
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3490353/
 
The Study of Neurocognitive Outcomes, Radiological and Retinal Effects of Aspirin in Sleep Apnoea- rationale and methodology of the SNORE-ASA study
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6753831/

Brain White Matter Changes in CPAP-Treated Obstructive Sleep Apnea Patients with Residual Sleepiness
https://www.ncbi.nlm.nih.gov/pubmed/27625326

       White matter structural differences in OSA patients experiencing residual daytime sleepiness with high CPAP use: a non-Gaussian diffusion MRI study.
       https://www.ncbi.nlm.nih.gov/pubmed/30445240

[Geoffrey]

Mesenteria, thank you for the thoughtful  response. I much appreciate your consideration. I have read that sleep apnea is directly linked to high levels of stress.

I was glad to hear that you feel as though memory areas in the brain very well might be restored.

Sorry to hear about your health problems.

[Geoffrey]

WillSleep, thank you for all the links. They all appear to show that there is brain loss with severe sleep apnea. However, they do not say whether it is recoverable or not.

[sheepless]

some of it must be recoverable. IDK if I'll ever be 'sharp' again after a lifetime of untreated apnea, but I do know I'm only half as useless now as 3 years ago when I couldn't maintain a train of thought, remember or accomplish much of anything. stress and anxiety ran high due largely to my inability to keep up with routine tasks, much less accomplish anything constructive or fun. although I'm a candidate, I haven't had heart or stroke problems (knock on wood) like some others here but stress and inactivity likely contributed to my currently being one test away from being dx'ed diabetic.

[Geoffrey]

Sheplees, thank you for your input. I am hopeful that all that stuff does not happen to yourself. Keep your chin up. I am pleased to hear that you had some success, so far as your memory is concerned.

[WillSleep]

I agree with mesenteria.  I think some is recoverable, or can be improved or we can gain access to brain capabilities we just had not before through healthy eating, physical exercise, and mental brain exercises.   

From checking on something for my wife's extended family a while back it seems like a strong google of the terms "stroke recovery", "memory recovery,"  "memory improvement," "preventing Alzheimer's" and "delaying Alzheimer's" might surface good action plans and tools to get busy working on it.  


Geoffery, 

Those links above were key articles so once open right-mouse-click on the "Similar Articles" and "Cited By" articles on the right side might surface another 100-200 links.   You might find more positive info in those or at least some helpful preventative info on how to better protect ourselves as we all age. 



I added the keywords CPAP, BIPAP, Recover, Restore, Improve to that query above and surfaced these links.  I have not read them but they might be directly focused on Improvement rather than talking about the damage.   The title of the first article looks a little scary but even if bad then maybe there is preventive information to learn.  

WillSleep


Effects of Long-Term Treatment on Brain Volume in Patients with Obstructive Sleep Apnea SyndromeHosung Kim, Eun Yeon Joo, Sooyeon Suh, Jae-Hun Kim, Sung Tae Kim, Seung Bong Hong   Hum Brain Mapp. Author manuscript; available in PMC 2017 Jan 1.   Published in final edited form as: Hum Brain Mapp. 2016
 
Neuroplasticity and Clinical Practice: Building Brain Power for Health
Joyce Shaffer   Front Psychol. 2016
 
Brain-Peripheral Cell Crosstalk in White Matter Damage and Repair
Kazuhide Hayakawa, Eng H. Lo   Biochim Biophys Acta. Author manuscript; available in PMC 2017 May 1.
Published in final edited form as: Biochim Biophys Acta. 2016 May; 1862(5): 901–908. Published online 2015 Aug 13. doi: 10.1016
 
White Matter Integrity in Obstructive Sleep Apnea before and after Treatment  2014
Vincenza Castronovo, Paola Scifo, Antonella Castellano, Mark S. Aloia, Antonella Iadanza, Sara Marelli, Stefano F. Cappa, Luigi Ferini Strambi, Andrea Falini
.
Clinical neurocardiology defining the value of neuroscience‐based cardiovascular therapeutics
Kalyanam Shivkumar, Olujimi A. Ajijola, Inder Anand, J. Andrew Armour, Peng‐Sheng Chen, Murray Esler, Gaetano M. De Ferrari, Michael C. Fishbein, Jeffrey J. Goldberger, Ronald M. Harper, Michael J. Joyner, Sahib S. Khalsa, Rajesh Kumar, Richard Lane, Aman Mahajan, Sunny Po, Peter J. Schwartz, Virend K. Somers, Miguel Valderrabano, Marmar Vaseghi, Douglas P. Zipes   J Physiol. 2016 Jul 15; 594(14): 3911–3954. Published online 2016
 
Sleep apnea: Altered brain connectivity underlying a working-memory challenge
Nicola Canessa, Vincenza Castronovo, Stefano F. Cappa, Sara Marelli, Antonella Iadanza, Andrea Falini, Luigi Ferini-Strambi
Neuroimage Clin. 2018

 

Hypoxic preconditioning improves long‐term functional outcomes after neonatal hypoxia–ischemic injury by restoring white matter integrity and brain development
Ming‐Yue Xu, Yang‐Fan Wang, Peng‐Ju Wei, Yan‐Qin Gao, Wen‐Ting Zhang
CNS Neurosci Ther. 2019 Jun; 25(6): 734–747. Published online 2019 Jan 28. doi: 10.1111/cns.13102
 
White Matter Injury and Recovery after Hypertensive Intracerebral Hemorrhage
Shilun Zuo, Pengyu Pan, Qiang Li, Yujie Chen, Hua Feng 
Biomed Res Int. 2017