Apart from having worse prognosis for cardiovascular, cerebrovascular and other high risk diseases, there are other ways that sleep apnea is making your everyday life difficult. One of these ways is a higher risk of vehicular crashes and automobile accidents. It seems that there is a great association of vehicular accidents with moderate or even severe obstructive sleep apnea.
Furthermore, research has shown sleep apnea to be a risk factor for cognitive disorders such as dementia, epilepsy, stroke, and several neuropsychiatric disorders like depression and post-traumatic stress disorder. Sleep apnea reduces the quality of life, causes rift in interpersonal relations and decreases the overall efficiency both in work and personal life.
As discussed before, sleep apnea negatively impacts the cerebral blood flow, neural regulation, neurotransmitter and other changes in the brain, thus contributing to cognitive decline resulting in dementia, decreased vigilance and even neural injury. Most of these changes in the brain are likely a consequence of decreased oxygen supply to the brain, an increase in the cerebral carbon dioxide levels and fragmentation of sleep. The brain of such patients adapts itself to survive on low oxygen levels, and one of the clinical manifestations of this adaptation is neural damage and dementia. Whether these changes are reversible or not, depends on the severity and stage of the disease.
However, such a complex interplay needs further research and study. Of the neuropsychiatric disorders, major depression and post-traumatic stress disorder (PTSD) are of particular importance. Since both these diseases are related independently with sleep disturbance. Although what exactly is the pathophysiology and the association between these disorders, is poorly understood yet.
Sleep apnea has also been implicated in poor memory due to its effect of dysfunctional memory consolidation as well as depotentiation of emotional memory. Moreover, it has been found in several studies that in healthy individuals with sleep apnea, there is a greater build-up of beta amyloid proteins in the cerebral spinal fluid, which are key pathological components of Alzheimer’s disease, axonal dysfunction and neuronal degeneration. These findings are suggestive of a strong correlation between sleep apnea and dementia.
A study in 2008 by neuroscientists at UCLA found that the area in the brain responsible for good memory function, the mammillary bodies, is nearly 20% smaller in sleep apnea patients, as compared to normal sleepers.
A study by Miguel Angel Martinez-Garcia and colleagues found a strong correlation between severe sleep apnea and increased aggressiveness of malignant melanoma. The findings of this study were presented at the American Thoracic Society conference, and suggested a higher prevalence of sleep apnea in patients who had aggressive cancers in accordance with the Breslow index. It was concluded at the end of the study that patients with cancer should be investigated for sleep related symptoms and treated accordingly.=
Sleep apnea prevalence is also increased in asthmatics; even though many non-asthmatics also suffer from sleep apnea, it is the asthmatic population who is found to be more at risk of the disease. Moreover, sleep apnea actually worsens the symptoms of asthma, by causing decreased airflow in the lungs and even inflammatory changes in the lungs. According to recent data, sleep apnea also has a strong effect on asthma exacerbations through neuromechanical reflex bronchoconstriction, inflammation and shortness of breath. Conversely, asthma can also cause sleep apnea through an increased likelihood of upper airway collapse, nasal obstruction and decreased cross sectional area of pharynx.