SLEEP 2026 | Obstructive sleep apnea and Alzheimer’s disease risk: toward personalized care

Yes, so, yeah, obstructive sleep apnea is associated with increased Alzheimer’s disease risk. When we look at racial, race-specific risk estimates, we’re seeing a burden for, let’s say, burden for obstructive sleep apnea, symptomatic obstructive sleep apnea. So that’s all I say with evidence of excessive daytime sleepiness. It’s more burdensome in populations that are understudied, like blacks, non-Hispanic blacks, Hispanics, or Asian-Americans even, or Native Americans. If we look on the other spectrum, where we’re looking at Alzheimer’s disease now, the burden as well, the prevalence is higher in these understudied populations, non-Hispanic black, Hispanic, with non-Hispanic black having two times the risk relative to non-Hispanic white, and with Hispanics, 1.5 times the risk to non-Hispanic whites. So you already see that. But I think we’ve asked the question to say, okay, if we look at mechanisms with respect to obstructive sleep apnea, where we’re looking at fragmentation, hypoxic measures, or duration or continuity measures. And what we try to do is look at each of these mechanisms that are known, physiologic processes that are known to be in OSA, obstructive sleep apnea, with the increased fragmentation, intermittent hypoxia and then continuity measures and then we looked at the risk of this particular mechanism and an incident dementia risk you do see you know, you see those responses basically meaning people who have more frequent fragmented sleep, people with higher hypoxic load or burden, right, or people with very short sleep duration, you see that risk. Then now we now look at racial ethnic differences in those risks, comparing the risk with each racial group. So across all ethnicity, all of this stuff I’ve mentioned is increased dementia risk. But then when you look at it between, you know, racial ethnic groups with those specific parameters, you’re basically seeing that duration and continuity measures impact the understudied populations the more. So, and then when you look at fragmentation measures, you’re seeing that females, right, are impacted more. When you look at hypoxia-disordered breathing measures, you’re seeing that understudied populations are impacted more. When you look at hypoxia disordered breathing measures in terms of males, females, you see that males are impacted more. You know, no difference in continuity with respect to male, female, or duration measures, but continuity, duration measures, you see that the understudied populations are impacted more. So the thought process is these mechanisms may also be driving some of the disparities in the outcomes that we’re seeing between obstructive sleep apnea and dementia risk across racial ethnic groups. And so, I mean, it ties to understanding specific mechanistic processes that, if a physician is sitting down in front of a patient, that may actually influence how you plan your treatment strategy. Knowing that you’re seeing a woman in front of you, you might think, okay, more fragmentation measures, maybe I can deal with that, right? You see an understudied person, you know, and you can get that history by talking, asking, it’s pretty self-explanatory, in my opinion. If you look at women, there’s certain stages in their lives, perimenopause, menopause. Sleep is really disrupted during that period. Or maybe if we come to younger-aged individuals, of course, we look at older adults, but a pregnancy, a new birth can disrupt sleep especially more impacting females more. And then when you look at you know duration measures the people who are more likely to stay in environments where there’s so much noise, close to highways, unsafe areas, a lot of noise will be underserved or understudied population. So, and you have people factor that in. Of course, you might not necessarily be prescribing medications for those purposes, but you can direct people to the appropriate resources to help because all of these impact health outcomes.

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