OSA Associated With Verbal Memory Deficits

[park_ridge_dave]

Only FWIW (which probably ain't much )

A month or so ago, before CPAP, I was really concerned that I had either early on set Alzheimers or that I was developing AADD. I couldn't remember engineering calculations or formulas that I have used for over 50 years!

I couldn't remember peoples names (Faces I could see in my mind's eye but just couldn't attach their names). Well, I have been on therapy for just over a month and It's like night and day different

So I, for one, believe that there is a strong link between OSA and lessened verbal acuity.

Now, I realize that this is an isolated anecdotal case, so I am drawing no conclusions about the general population. But it is great to have a life again

Maybe, I should call the plant and see if they would take me back Arrrrrrrrgh what was I thinking

Cheers,

Dave

[fidelfs]

just a question, People experiencing short term memory problems. Do you recently experience that or it If you can "remember" you have been always like that?

[BigNortherner]

OTOH, don't get pregnant?

http://www.timescolonist.com/life/Harri ... story.html

[patdart]

just a question, People experiencing short term memory problems. Do you recently experience that or it If you can "remember" you have been always like that?

I've been thinking about this and I have always had a memory problem now that you ask. I remember my mother getting really upset with me when I failed to remember how many days there were in a year once when I was about 16. Of course, I knew and a few minutes later it came to me. Still happens that way...

I view my memory like one of those tumbling machines used for games...it tumbles around and nearly always the right cube finally comes out!

Pat

[patdart]

This brings up a question I've long wondered about...I believe I've had this problem to some extent since childhood. Sleep was hard for me then because I'd wake up with my heart pounding and adrenaline pumping and that has quit happening for me now since I started cpap treatment. Does anyone else relate to this?

Pat

[BigNortherner]

I know someone under age 30 who had OSA.

He opted for surgery to the offending tissues, after first having sinus surgery, and was very pleased with the result. I haven't talked to him for a couple of years so I don't know if success has lasted (it's been suggested to me that the offending tissues can grow back - it is early for him).

(That's the result after recovery from surgery - worth the result but not comfortable.)

[JockLitt]

Hi guys,

I haven't been on the forum for a while - bit of work pressure made worse by the memory problem. This is a major issue with sleep apnea. As some of you may remember from a few months ago, I 've been going through some challenges of my own in this respect. My cardiologist - yes - another recent problem, says that medical science is only beginning to scratch the surface of the long term effects of OSA. Anyway, enough from me. Here is some light reading for those of you who are not easily depressed, and also for those of you who too depressed to care.

We've got to try and lighten up - if you don't laugh you cry.

Cheers,

Jock


Brain Death by a Thousand Hypoxic Cuts in Sleep
Brian J. Murray, M.D.
Sunnybrook Health Sciences Centre, Toronto, Canada and University of Toronto, Toronto, Canada
Evidence supporting the role of obstructive sleep apnea in the pathogenesis of ischemic stroke continues to emerge. Obstructive sleep apnea is a risk factor for the development of hypertension (1), and hypertension is known to be a significant stroke risk factor. Further recent evidence has identified obstructive sleep apnea as a risk factor for stroke (2), even independent of its association with hypertension and other comorbid conditions (3). Several mechanisms may contribute to the development of ischemic stroke in patients with sleep apnea. For example, a recent study demonstrated that apnea-related hypoxia was associated with systemic inflammation and the progression of carotid atherosclerosis as measured by ultrasound (4).
In this issue of the Journal (pp. 612–617), Minoguchi and colleagues provide further important observations on the association between stroke and obstructive sleep apnea, with significant public health implications (5). The authors, using brain magnetic resonance imaging, demonstrate that patients with obstructive sleep apnea have a higher incidence of so-called silent brain infarctions (i.e., those devoid of obvious clinical symptoms leading to self-detection or identification by physician examination). This well-designed and executed study excluded patients with known risk factor comorbidities, thereby establishing the relationship between brain infarcts and obstructive sleep apnea itself. The significance of this finding pertains not only to stroke pathophysiology but to dementia as well.
Clinically identified stroke represents the tip of the iceberg in terms of cerebral vascular disease by at least an order of magnitude (6). Small, but strategically placed, lesions in the brain can produce a clinically obvious stroke. For example, a lesion of only a few millimeters in diameter that is located in the posterior limb of the internal capsule may leave a patient with devastating hemiplegia that would be obvious clinically. The need to prevent these types of strokes from developing is obvious.
Silent infarctions identified on routine neuroimaging studies, on the other hand, may occur in areas of the brain that can only be detected clinically by detailed neuropsychological assessment—or perhaps not at all with currently available tests. It is hard to believe, however, that loss of brain tissue should go without consequences. The brain may reorganize functional networks to adapt to lesions and recover function, but with each subsequent stroke, the capacity to do so is diminished. This may at least partially account for the finding that patients with stroke and obstructive sleep apnea tend to have a longer rehabilitation stay and worse functional recovery than those patients without obstructive sleep apnea (7).
The question is then raised as to how often obstructive sleep apnea may be contributing to subtle cognitive impairment, or even overt dementia. "Silent" brain infarcts are known to contribute to dementia (8), and even a small strategic infarction of the anterior thalamus may be associated with clinically overt dementia (9). Vascular disease is the second most common cause of dementia (10), and is often seen as a contributor in mixed states with Alzheimer's disease. Recurrent hypoxic stress from apnea may be triggering small strokes, whose effects eventually accumulate, with dementia as a consequence. Some groups of patients may be more susceptible to this injury than others. A study of patients with the apolipoprotein E 4 allele, who are at greater genetic risk for sleep apnea (11) and dementia, demonstrated that cognitive decline correlated with recurrent respiratory events in sleep (12). Some of the clinical impairment may represent daytime sleepiness from sleep loss, which subsequently impairs vigilance and attention that is fundamental to all other neuropsychological tasks. Attention and dependent neuropsychological functions may therefore improve with improved sleep quality after treatment of sleep apnea. On the other hand, loss of brain tissue from infarction is not reversible. This may explain why not all neuropsychological deficits attributed to obstructive sleep apnea resolve after treatment. Secondary prevention is therefore paramount.
White matter changes of varying degrees are common incidental findings in neuroimaging studies, and the significance in an individual patient is not always clear; the cause is often even less evident. Intermittent hypoxia has been hypothesized as a potential factor (13) among many that may contribute to white matter abnormalities. The study by Minoguchi and colleagues provides evidence that at least some of these white matter lesions are related to apnea. These findings should now trigger a clinician to consider the possibility that sleep apnea may be contributing to the development of white matter lesions, and lead the physician to seek appropriate investigations. This may be important as treatment of obstructive sleep apnea may help reduce the burden of the clinical condition that leads to neuroimaging in the first place. For example, silent infarcts and even diffuse white matter changes are a risk factor for stroke (14), so the treatment of obstructive sleep apnea is of particular importance for secondary stroke prevention.
Treating obstructive sleep apnea with continuous positive airway pressure appears to reduce the incidence of clinically obvious stroke (15). The study by Minoguchi and colleagues provides a novel potential mechanism for this finding. In particular, those patients with silent infarcts and sleep apnea had elevated markers of platelet activation, such as soluble CD40 ligand and soluble P-selectin. Furthermore, continuous positive airway pressure therapy for 3 months can lower such markers in this population, thereby providing a link between the white matter lesions and their pathogenesis. Treatment with continuous positive airway pressure may therefore lead to a reduced incidence of subsequent ischemic brain lesions. The high prevalence of obstructive sleep apnea has significant implications for stroke and dementia in our aging population, particularly as obesity becomes more common. Finding ways to reduce brain ischemia is indeed important to the individual and to our society, as stroke and dementia provide tremendous economic and personal burdens (16).

[dsm]

just a question, People experiencing short term memory problems. Do you recently experience that or it If you can "remember" you have been always like that?

I've been thinking about this and I have always had a memory problem now that you ask. I remember my mother getting really upset with me when I failed to remember how many days there were in a year once when I was about 16. Of course, I knew and a few minutes later it came to me. Still happens that way...

I view my memory like one of those tumbling machines used for games...it tumbles around and nearly always the right cube finally comes out!

Pat

I have formulated a great excuse for my memory lapses. I merely claim that my head has a lifetime's data accumulated in it and the sorting algorithm is getting slower by the decade. As I got older & the data volume increased I had to master the art of ignoring much of what I was taking in & the selection process was to deliberately switch off to any data I believed I could track down through external sources (books & internet etc: ). Who wants to clog their brain with 65 years of intricate detail ?. Not I

So when I can't remember some answer to a posed question & the answer doesn't pop up immediately I will say, that the question is queued & the answer will get paged in from stored memory perhaps in the next 24-36 hrs (that seems to be the current search & sort time ).

Interestingly many such answers will emerge in my dreams or sleep (Eureka! - I have it).

The above story works for me no matter how many of my ancestors had Alzheimer's

DSM

PS - I really dislike being distracted from any intent task am working on. See it as an intrusive & unwanted disruption to a good process & the disruption may damage the quality of what was being processed

[BigNortherner]

In addition to stress and rushing, which the mommie article highlights, another reason for memory problems IMJ is poor habits. Many people jump around in conversations instead of listening and thinking which reinforces memory.

I have to watch in reading that I proceed through the article to ensure I see everything. (Even worse would be only reading the headline, given how misleading they are these days – even backwards in some cases.)


As noted by DSM, concentration is necessary. (For comprehension and noticing all factors, in my experience. Some studies show narrowing of focus when fatigued, thus high risk of missing errors and unexpected factors. Multi-tasking is fine in some contexts but dangerous in others.

I also note that people don’t write things down. I long have, and my father did. Writing down may help reinforce in memory, but some things should be deliberately memorized so they are more likely to be remembered when needed quickly. Memory is variable, one problem is remembering an earlier version – so it a belief was corrected or something changed you may remember the earlier version especially under stress. And there’s thinking of something when I wake up in the middle of the night – that’s why I keep a pad of paper to make cryptic notes when things are hectic – check it at the end of the work day for example.