Gonzalo Labarca Trucios, MD: Arousal Intensity in Sleep Apnea Tied to Higher Dementia Risk

In an interview at SLEEP 2023 in Indianapolis, IN, Gonzalo Labarca Trucios, MD, instructor in medicine at the Brigham and Women's Hospital, Harvard Medical School, detailed the data behind his presentation "Novel OSA-Driven Metric Predicts Incident Dementia in Sleep Apnea in 2 Different Community-Based Cohort Studies".

The study showed high arousal intensity, as measured by the number of electroencephalographic arousals per hour of sleep, was independently associated with an increased risk of incident dementia in 2 independent cohorts of individuals with obstructive sleep apnea.¹

"We already know that obstructive sleep apnea is a prevalent disease, with several comorbidities," he said. Probably, people who are not treated have an increased risk of dementia, neurocognition impairment, cardiovascular disease, and other worse health outcomes."

In the MrOS cohort, Labarca Trucios and his team observed arousal events in 11.4% of men, and each 1 standard deviation (SD) increase in arousal intensity was associated with a 23% higher risk of incident dementia (95% CI, 0 - 50; P < 0.05).

"In the last 5 years, there has been a shift in focus towards improved phenotyping of sleep apnea defining subtypes," he explained.

In the MESA cohort, 3.5% of men experienced arousal events, and each increase in arousal intensity was associated with a 29% increased risk of incident dementia (95% CI, 1 - 65; P < 0.05).

"If you are a severe sleep apnea patient with a very high arousal intensity, your risk (for dementia) is almost 80%," Labarca Trucios said. "That's something that is consistent: that this phenomenon is associated with sleep apnea."

The MrOS study included 1136 participants (median age, 76 years; 100% male) and MESA consisted of 1923 participants (median age 67; 46.3% male).

"The conclusion is–when you start your study, to identify this population, you also have this new prognostic metric, and you have to give more attention to people who have higher arousal because they probably have an increased risk of dementia," he explained.

References:

1. Trucios GL, Esmaeili N, Hu W, et al. 0830 Novel OSA-driven metric predicts incident dementia in sleep apnea in two different community-based cohort studies. SLEEP. 2023;46(Supplement_1):A365-A366.