Moderate to Severe OSA May Raise Risk for Cerebral Microbleeds
Key Clinical Summary
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Among 1441 adults followed for 8 years, moderate to severe obstructive sleep apnea (OSA; ≥15 events/h) was linked to a 2.14-fold higher risk of incident cerebral microbleeds (CMBs) vs no OSA, after multivariable adjustment.
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CMBs occurred in 7.25% with moderate–severe OSA vs 3.33% without OSA at 8 years; no elevated risk was seen for mild OSA.
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Findings highlight OSA as a modifiable cerebrovascular risk factor, underscoring the need for early diagnosis and treatment to help prevent stroke and dementia.
Moderate to severe obstructive sleep apnea (OSA) is independently linked with an increased risk of incident cerebral microbleeds (CMBs) over 8 years, according to a population-based study published online in JAMA Network Open.
“Given that OSA is a modifiable risk factor, this finding suggests that moderate to severe OSA should be a potential target for early diagnosis and treatment to prevent incident CMBs and potentially prevent future strokes and dementia in aging populations,” wrote corresponding author Chol Shin, MD, PhD, of the Korea University College of Medicine, Seoul, South Korea, and study coauthors.
The prospective cohort study included 1441 participants from a Korean community who underwent in-home overnight polysomnography and brain magnetic resonance imaging at baseline and at 4- and 8-year follow-ups. Among the participants, 436 had mild OSA (5.0-14.9 events/h), 193 had moderate to severe OSA (≥15.0 events/h), and 812 had no OSA at baseline.
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By 4 years, incident CMBs had occurred in 15 participants (1.85%) without OSA, 7 participants (1.61%) with mild OSA, and 9 participants (4.66%) with moderate to severe OSA, according to the study. By 8 years, CMBs had occurred in 27 participants (3.33%) without OSA,14 participants (3.21%) with mild OSA, and 14 participants (7.25%) with moderate-to-severe-OSA group, according to the study.
In models adjusted for various demographic, lifestyle, and health factors, participants with moderate to severe OSA had a 2.14 relative risk of developing CBMs at 8 years compared with participants without OSA, researchers reported. No significantly increased risk was observed at the 4-year follow-up for moderate to severe OSA, and mild OSA was not associated with an increased CMB risk at any time.
In a sensitivity analysis adjusted for APOE-ε4 carrier status, a genetic trait associated with CBMs, the 8-year increased risk of CMBs with moderate to severe OSA remained significant.
“These results,” researchers wrote, “add to the evidence for the importance of sleep apnea to brain health.”
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