Obstructive sleep apnea may be risk factor for Parkinson's
Veterans with obstructive sleep apnea (OSA) had 1.61 additional cases of Parkinson's disease per 1,000 patients at six years from diagnosis versus those without OSA, and early use of continuous positive airway pressure appeared to help mitigate that risk, a cohort study found.
Obstructive sleep apnea may increase future risk for Parkinson's disease, according to a recent cohort study of U.S. veterans.
Researchers used data from the electronic health record (EHR) to evaluate whether obstructive sleep apnea was associated with incident Parkinson's disease among U.S. veterans and whether treatment with continuous positive airway pressure (CPAP) modified risk. The study used data from 1999 through 2022, with a mean follow-up of 4.9 years. Cumulative incidence of Parkinson's disease was the primary outcome. The results were published Nov. 24 by JAMA Neurology.
Overall, 11,310,411 veterans (81.0% White; 9.8% women; mean age, 60.5 years) were included in the study. A total of 1,552,505 (13.7%) had obstructive sleep apnea, and 144,643 (9.3%) had use of CPAP mentioned in their medical records. Those with obstructive sleep apnea had a greater cumulative incidence of Parkinson's disease beginning at two years from the start of follow-up. At six years, patients with obstructive sleep apnea had 1.61 (95% CI, 1.13 to 2.09) additional cases of Parkinson's disease per 1,000 compared to those without obstructive sleep apnea.
Results were similar after adjustment for body mass index, vascular comorbidities, psychiatric conditions, and relevant medications, but women veterans with obstructive sleep apnea were at higher risk for Parkinson's than men (hazard ratio [HR], 4.24 [95% CI, 2.69 to 6.68] vs. 2.21 [95% CI, 1.78 to 2.74]). When patients received early treatment with CPAP, defined as mention of CPAP in the EHR within two years of diagnosis of obstructive sleep apnea, cases of Parkinson's disease were significantly reduced.
The authors noted that they weren't able to fully assess CPAP adherence or consider cognitive, social, or physical factors that may have affected it, among other limitations.
“In conclusion, in this cohort study, our findings suggest that US veterans with [obstructive sleep apnea] had a significantly higher risk of developing [Parkinson's disease], and this risk was reduced with early CPAP intervention,” they wrote. “These data establish additional clinical rationale for early screening and intervention of sleep-disordered breathing as a key strategy in supporting brain health.”