Apnea may lead to dementia

[devinf]

Saw this article in today's SF Chronicle. Thought I'd share.

http://www.sfgate.com/cgi-bin/article.c ... 1KLC2V.DTL

Devin

[wolewyck]

Here are links to the full article:

http://jama.ama-assn.org/content/306/6/613.full

http://jama.ama-assn.org/content/306/6/ ... l.pdf+html

[JointPain]

Patients already on CPAP were excluded from the study above, but I found the following quote from the article to be another good reason to love my hose: Furthermore, a recent investigation of individuals with sleep apnea indicated that treatment with CPAP not only improved cognitive scores, but also increased gray matter volume in the hippocampal and frontal regions.

[Slartybartfast]

Re: the original article, that's lazy science. Association is not causation. It's entirely possible that the manifestation of dementia and sleep apnea are both merely symptoms of an underlying condition that causes both of them. Rather than reporting a conclusion from the data, they need to first test their hypothesis, and then form a conclusion, not short-circuit the scientific method and report their conclusion before they've actually done the work.

[DaveLP]

100% of people who eat broccoli will die at sometime in their life. This is proven to be fact.

[Otter]

Furthermore, a recent investigation of individuals with sleep apnea indicated that treatment with CPAP not only improved cognitive scores, but also increased gray matter volume in the hippocampal and frontal regions.

Mainstream press version:

CPAP Therapy Causes Brains to Grow
CPAP therapy has been found to affect the brains of obese patients. Sleep apnea is a common complication of obesity which interferes with breathing during sleep. CPAP therapy delivers compressed air through a mask while the patient is sleeping to prevent sleep apnea. A recent research study indicates that CPAP also causes the brain to grow. The researchers have not determined if the heads of people with CPAP-induced megacephaly return to normal after weight loss, or how the increased brain size affects intelligence. However intracranial swelling is known to cause brain damage and even death.

[Otter]

Re: the original article, that's lazy science. Association is not causation. It's entirely possible that the manifestation of dementia and sleep apnea are both merely symptoms of an underlying condition that causes both of them. Rather than reporting a conclusion from the data, they need to first test their hypothesis, and then form a conclusion, not short-circuit the scientific method and report their conclusion before they've actually done the work.

Yes. I'm not sure that would be science at all. But they didn't claim to have demonstrated a causal link.

Authors of the dementia study said their work wasn't designed to describe exactly what happens in the brain that creates the association between sleep apnea and cognitive impairment. But because their study clearly showed a relationship between hypoxia - or low levels of oxygen for sustained periods of time during sleep - and dementia, that's probably a good place to focus subsequent studies, they said.

[Slartybartfast]

\Yes. I'm not sure that would be science at all. But they didn't claim to have demonstrated a causal link.

Yes, but they don't have to. The implication is there. And when others then cite the study, and others cite them, the distinction somehow is lost. And then we get to the point we are today where "low cholesterol" foods are recommended to people who are concerned about heart disease, when no causal link was ever established between cholesterol consumption and heart disease.

[JointPain]

Actually, what worried me most about the original study was that they let all these people with OSA continue on no therapy, so that they could collect their study data. Dementia aside, untreated sleep apnea has lots of known side effects and the people in this study were placed at unnecessary risk. In the studies I have knowledge of, all people in the trial receive standard of care. That doesn't seem to be the case here.

[Otter]

\Yes. I'm not sure that would be science at all. But they didn't claim to have demonstrated a causal link.

Yes, but they don't have to. The implication is there. And when others then cite the study, and others cite them, the distinction somehow is lost.

Now that would be sloppy science. Things tend to get distorted in the popular press, but any good scientist will actually read the studies he cites.

The implication is an obvious need for more research, and they said that. I think there's a very good chance that untreated OSA does contribute to dementia. It certainly affected my cognitive abilities, and I'm not even 50 yet. But that's just a hunch that needs to be tested. How exactly could you do this research and avoid other people jumping to the obvious conclusion, though?

And then we get to the point we are today where "low cholesterol" foods are recommended to people who are concerned about heart disease, when no causal link was ever established between cholesterol consumption and heart disease.

And that's sloppy medical practice, especially now that there has been plenty of time to test that link, and the results have been negative. That's not really the fault of these guys though. Essentially what they said is, "Hey, there's something here. Somebody should check it out and see what it is." They emphasized that enough to the reporter that she bothered to print it. I don't think they're responsible for the idiots playing chinese telephone with their conclusion after that.

Don't get me wrong. I agree with your basic gripe. I just don't think it applies to this particular study.