New findings indicate that people who do not treat obstructive sleep apnea face a greater likelihood of developing Parkinson’s disease. Using continuous positive airway pressure, or CPAP, can help lower that risk by improving sleep quality and maintaining steady airflow throughout the night.
The study was published on November 24 in JAMA Neurology and analyzed electronic health records from more than 11 million U.S. military veterans who received care through the Department of Veterans Affairs between 1999 and 2022.
Researchers from Oregon Health & Science University and the Portland VA Health Care System led the project.
Parkinson’s Risk Increases With Age
Parkinson’s is a progressive neurological disorder that affects an estimated 1 million people in the United States. The chance of developing the disease grows gradually each year after age 60.
The new research suggests that long-term, untreated sleep apnea may contribute to a higher risk of Parkinson’s.
Strong Association After Adjusting for Key Factors
Even after accounting for important contributors such as obesity, age and high blood pressure, the investigators still found a clear association between untreated sleep apnea and Parkinson’s disease. Among the millions of veterans with sleep apnea, those who did not use CPAP were nearly twice as likely to be diagnosed with Parkinson’s compared with individuals who used the therapy.
“It’s not at all a guarantee that you’re going to get Parkinson’s, but it significantly increases the chances,” said co-author Gregory Scott, M.D., Ph.D., assistant professor of pathology in the OHSU School of Medicine and a pathologist for at the VA Portland.
How Sleep Apnea Affects the Brain
Sleep apnea occurs when a person’s breathing repeatedly stops and restarts during sleep, which can keep the body from getting sufficient oxygen.
“If you stop breathing and oxygen is not at a normal level, your neurons are probably not functioning at a normal level either,” said lead author Lee Neilson, M.D., assistant professor of neurology at OHSU and a staff neurologist at the Portland VA. “Add that up night after night, year after year, and it may explain why fixing the problem by using CPAP may build in some resilience against neurodegenerative conditions, including Parkinson’s.”
Potential to Change Clinical Practice
Neilson said the results reinforce the importance of prioritizing sleep health for his patients, particularly in light of the elevated Parkinson’s risk revealed in the study.
“I think it will change my practice,” he said.
Veterans Report Clear Benefits From CPAP
Scott noted that some people with sleep apnea are hesitant to use CPAP, but he emphasized that many veterans have strongly positive experiences with the device.
“The veterans who use their CPAP love it,” he said. “They’re telling other people about it. They feel better, they’re less tired. Perhaps if others know about this reduction in risk of Parkinson’s disease, it will further convince peopel with sleep apnea to give CPAP a try.”
Study Contributors and Funding Support
In addition to Scott and Neilson, co-authors include Isabella Montano, B.A., Jasmin May, M.D., Ph.D., Jonathan Elliott, Ph.D., and Miranda Lim, M.D., Ph.D., of OHSU and the Portland VA Health Care System; and Yeilim Cho, M.D., and Jeffrey Iliff, Ph.D., of the University of Washington and the VA Puget Sound Health Care System.
The research received support from the VA through grant awards BX005760, CX00253, I01RX004822, I01RX005371, CX002022, BX006155 and Bx006155; the John and Tami Marick Family Foundation; the Collins Medical Trust; the National Institute on Aging of the National Institutes of Health, award P30AG066518; and the U.S. Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick, Maryland 21702-5014, under award numbers HT9425-24-1-0774 and HT9425-24-1-0775. The authors note that the opinions, interpretations, conclusions and recommendations are their own and are not necessarily endorsed by the Department of Defense, the NIH, VA or other funders.
