In our work with obstructive sleep apnea, we have seen that, not only is OSA cross-sectionally associated with increased Alzheimer’s disease risk, we see that there’s a possibility with some of our longitudinal studies that obstructive sleep apnea can precede the onset of Alzheimer’s disease. Now, one of the things that we thought would be very important was to look at the relationship or association with the pathology of Alzheimer’s disease or the pathophysiological markers, so like amyloid or tau...
In our work with obstructive sleep apnea, we have seen that, not only is OSA cross-sectionally associated with increased Alzheimer’s disease risk, we see that there’s a possibility with some of our longitudinal studies that obstructive sleep apnea can precede the onset of Alzheimer’s disease. Now, one of the things that we thought would be very important was to look at the relationship or association with the pathology of Alzheimer’s disease or the pathophysiological markers, so like amyloid or tau. And what we did, what we saw was not only is obstructive sleep apnea associated, that it can be a modifier of disease progression. And what I mean by that is when you look at an individual who has obstructive sleep apnea, for example, and you look at an individual without obstructive sleep apnea, and then you look at an individual that has amyloid pathology, no obstructive sleep apnea, and then you look at an individual that has co-occurring obstructive sleep apnea with some amyloid pathology that is above a setting threshold that we say the person is amyloid positive, we do see that the co-occurring OSA amyloid pathology is synergistic such that those individuals have a shorter time to progression, from cognitively normal to MCI or MCI to Alzheimer’s disease. And so using that thought process, that’s what we looked at individuals who are just sleep-disturbed. So using the neuropsychiatric inventory questionnaire, there’s the questions in there that are sleep-related. So this is not like an objective, necessarily objective way of quantifying sleep problems, but they’re relevant. The NPIQ is a validated measure, so we use the sleep metric there, measures there, and characterized sleep disturbance. And we basically, what I just described, are seeing very similar findings. An individual who is sleep disturbed and has evidence of amyloid pathology, right, has a very strong effect with tau. And tau pathology, as we know, correlates with symptom onset or symptomatology. So we’re seeing that there’s a very strong possibility that sleep disturbance, just like we’re seeing in the disorder of obstructive sleep apnea, can modify the AD risk, right, depending on, a certain level of amyloid pathology.
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