The longitudinal effect of sleep apnea on changes in brain structure in a population-based sample
Antoine Weihs1,2, Stefan Frenzel2, Katharina Wittfeld2
1German Centre for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany.
Sleep
|January 10, 2026
Summary
Sleep fragmentation, not traditional sleep apnea indices, significantly impacts brain structure over time. Addressing sleep fragmentation may protect the brain from atrophy and aging.
Area of Science:
- Neuroscience
- Sleep Medicine
- Radiology
Background:
- Sleep apnea is increasingly recognized as a modifiable risk factor for neurodegeneration.
- Longitudinal studies are crucial to understand the impact of sleep apnea on brain health over time.
Purpose of the Study:
- To investigate the longitudinal effect of sleep apnea on brain structures in a general population.
- To determine if traditional sleep apnea indices or sleep fragmentation are associated with structural brain changes.
Main Methods:
- Utilized data from the Study of Health in Pomerania, including baseline and 7-year follow-up MRI and polysomnography.
- Assessed sleep apnea using AHI, ODI, SpO2, and arousal index; sleep quality via ESS and PSQI.
- Analyzed brain volume, grey matter thickness, white matter hyperintensities, and brain age using linear regression and restricted cubic splines.
Main Results:
- Neither apnea-hypopnea index (AHI) nor oxygen desaturation index (ODI) showed significant longitudinal effects on brain structures.
- Lower mean sleep oxygen saturation (SpO2) was linked to reduced total brain volume.
- Higher arousal index correlated with increased brain age and decreased grey matter thickness, indicating sleep fragmentation's impact.
Conclusions:
- Traditional sleep apnea indices (AHI, ODI) were not associated with structural brain changes over a 7-year period.
- Sleep fragmentation, indicated by the arousal index, emerged as a significant factor in brain atrophy and accelerated brain aging.
- Targeting sleep fragmentation may represent a novel neuroprotective strategy.
Related Concept Videos
01:21Sleep Apnea
465
Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
The condition is more prevalent among...
465
02:20Longitudinal Research
13.1K
Sometimes we want to see how people change over time, as in studies of human development and lifespan. When we test the same group of individuals repeatedly over an extended period of time, we are conducting longitudinal research. Longitudinal research is a research design in which data-gathering is administered repeatedly over an extended period of time. For example, we may survey a group of individuals about their dietary habits at age 20, retest them a decade later at age 30, and then again...
13.1K
01:26Longitudinal Studies
468
Longitudinal studies are also widely used in other medical and social science fields. For instance, in cardiovascular research, they can monitor patients' health over decades to identify risk factors for heart disease, such as high cholesterol or smoking, and evaluate the long-term effectiveness of preventive measures. Similarly, in mental health studies, researchers might follow individuals from adolescence into adulthood to understand the development and progression of conditions like...
468
01:24Substance Use Disorders Affecting Sleep
394
Substance use disorders involve a pattern of using drugs more extensively than intended and continuing use despite harmful consequences. This includes legal substances like alcohol and nicotine, as well as illegal drugs. These disorders often involve both physical and psychological dependence, reflecting compulsive use of substances that significantly alter thoughts, feelings, and behaviors, contributing to a major public health issue.
Understanding the concepts of physical dependence,...
Understanding the concepts of physical dependence,...
394
01:24Sleep-Wake Cycles
2.7K
Sleep is an essential physiological process vital to maintaining overall well-being. The reticular activating system (RAS), a network of neurons in the brainstem, regulates wakefulness and sleep. While it may seem passive, sleep consists of distinct cycles, each with its unique characteristics and functions. Two key sleep phases are non-rapid eye movement (NREM) and rapid eye movement (REM).
NREM Sleep
NREM sleep comprises four progressive stages that seamlessly merge:
NREM Sleep
NREM sleep comprises four progressive stages that seamlessly merge:
2.7K
01:11Understanding Sleep
1.4K
Sleep, an essential biological state, involves significant reductions in physical activity, sensory awareness, and interaction with the environment. This complex physiological process is primarily regulated by specific brain regions, notably the hypothalamus and pons, which govern the sleep-wake cycle or circadian rhythm.
The circadian rhythm, a nearly 24-hour cycle, is deeply influenced by environmental light cues. Light exposure directly affects the hypothalamus, which in turn regulates...
The circadian rhythm, a nearly 24-hour cycle, is deeply influenced by environmental light cues. Light exposure directly affects the hypothalamus, which in turn regulates...
1.4K