‘I Discovered I Had Obstructive Sleep Apnea—Here’s How It Affected My Brain’

Two years ago, I started waking up exhausted. It didn’t matter how long I slept. I’d find myself nodding off at my computer. Whenever I’d try to write, I’d struggle to find the right words, string together sentences, and concentrate. I gained weight, my blood pressure and cholesterol went up, and I was worried.

It took me about a dozen appointments with various doctors and specialists before I finally got a diagnosis. And it wasn’t an easy road. One cardiologist dismissed my symptoms and told me I was just lazy and needed to exercise more (even though I didn’t have the physical energy).

Eventually, an endocrinologist told me my high cholesterol was probably caused by a condition called obstructive sleep apnea, which causes the airways in the lungs to collapse while I slept, leading to my other symptoms. 

I underwent testing with a sleep specialist and discovered that yes, in fact, I did have a very severe form of the disorder. My airways, doctors found, collapsed 60 times per hour while I slept. My oxygen levels would drop. These disruptions meant my body would wake up gasping for air and prevent me from entering the restorative part of the sleep cycle. Once I started using a special machine to help keep my airways open, my sleep and other symptoms began improving. 

I’m far from the only person whose weird symptoms might be explained by obstructive sleep apnea. Scientists and doctors, including Dr. Ricardo Osorio at NYU Langone Health, have become interested in studying the impact of obstructive sleep apnea on brain health because it is the most common sleep disorder, affecting almost 40 million Americans. 

Since sleep apnea affects the quality of sleep, it might also increase the risk of Alzheimer’s and dementia. In the last decade, a lot of new research has found that a good night’s sleep helps flush away plaques like beta-amyloid associated with Alzheimer’s disease. Osorio explained that the link between Alzheimer’s and sleep apnea, like with other risk factors for the disease, is very nuanced and complicated. 

The link between sleep apnea and Alzheimer’s

Like dementia, obstructive sleep apnea can be seen as an umbrella term encompassing many different types of conditions that make it difficult to breathe in and out while sleeping. 

“There are people that have what we call sleep apnea with consequences,” Osorio said, meaning they develop an increased risk for high blood pressure, diabetes, cancer, and dementia. “Some people that have sleep apnea may never develop dementia, and some people that have normal sleep will develop Alzheimer’s disease.”

He also said that sleep apnea could lead to symptoms of mild cognitive impairment — forgetfulness, confusion, and difficulty concentrating.

Diagnosing obstructive sleep apnea

The first step toward getting a sleep apnea diagnosis is spotting the symptoms. 

“One of the challenges that we have with sleep apnea is that many people are asymptomatic or unaware of their symptoms,” Osorio said. The symptoms of obstructive sleep apnea — daytime sleepiness, headaches, and snoring — can go unnoticed or ignored since they don’t always feel serious. 

Fortunately, if someone does visit their doctor, one of the easiest ways to screen for obstructive sleep apnea involves an at-home test. Osorio said these tests involve wearing a pulse oximeter — a small device that goes onto your finger to measure oxygen levels — and a device on your wrist while you sleep to measure your snoring and quality of sleep. He said these at-home tests can be perfect for spotting moderate or severe levels of obstructive sleep apnea.

But sometimes, a diagnosis might require more intense testing, nocturnal polysomnography, at a specialized sleep center. It involves attaching electrodes to your scalp to measure brain waves while you sleep and attaching sensors to your legs, chest, and face to assess muscle movement and heart and lung function. 

(Ironically, some people find sleeping difficult with all these wires and devices attached.)

Treating sleep apnea

While there are ways to treat the underlying symptoms of sleep apnea, that doesn’t mean that the condition will go away. Many people may need a machine to help them breathe while they sleep permanently, while others might go into remission. 

Continuous positive airway pressure machine (CPAP)

A CPAP machine is helpful for most, but not all, people diagnosed with sleep apnea. It is a small box with a tube connecting to a face mask worn while you sleep. The machine blows air into your lungs at constant pressure to keep the airways from collapsing.

Bilevel positive airway pressure machine (BiPAP)

For some people, a CPAP machine doesn’t work. When obstructive sleep apnea is particularly severe, or there are other underlying conditions, like heart failure, which also affect the ability to breathe in and breathe out. 

This is where the BiPAP comes in. The BiPAP delivers air at a higher pressure to help the airways stay open while inhaling and a lower pressure when breathing out to make it easier to exhale. 

Lifestyle changes

Doctors often recommend some lifestyle changes for sleep apnea:

• Eating healthier: Reducing the amount of junk food in your diet and eating more fruits, vegetables, legumes, and whole grains. This may also help to lower blood pressure, cholesterol, and your risk of Alzheimer’s disease.
• Exercise: This helps blood flow to your brain, improves sleep quality, and may reduce the risk of Alzheimer’s disease.

However, more research is needed to determine which interventions are best for people depending on their sleep apnea severity and gender. Right now, most of the studies have been conducted in men with moderate to severe obstructive sleep apnea.

Another caveat I discovered was that exercising and eating healthier became a lot easier after I got my BiPAP machine. When you’re exhausted, you are a lot less likely to eat healthily and have a lot less energy to go outside and exercise — which can contribute to the cycle of poor sleep.

How much does treatment cost?

A sleep study can cost anywhere from $150 for an in-home study to $10,000 at a sleep center. Many private insurers might cover most of the cost if the sleep study is done with a preferred provider or center with which the insurance company already has a pre-existing relationship. Medicare covers 80 percent of the costs for the study so long as it comes through a doctor referral.

A CPAP machine can cost between $500 to $1000, but many private insurers cover the cost and other accessories, such as masks and cleaning supplies. Medicare will also cover a three-month trial of therapy with a CPAP machine. After the trial, it can continue covering the therapy, devices and accessories if you meet with a doctor in person. That doctor fills out medical records that indicate you meet certain eligibility criteria and that the treatment is helping you. 

A BiPAP machine can cost between $1700 and $3000 and might not be covered by some private insurers. It will only be covered by Medicare if a CPAP device is shown to be ineffective in treating your symptoms. 

Can treating sleep apnea boost your brain health?

People with conditions like diabetes or high blood pressure are often at a higher risk of developing Alzheimer’s and other forms of dementia. Treating these underlying risk factors can help people lower their risk of developing the disease. 

But is the same true for sleep apnea? Osorio said that we don’t know yet. 

“This has to do more with the challenges of doing clinical trials on sleep apnea because people are so bad at using the machine.” In many of these trials, people don’t use their CPAP or BiPAP machine every night. Sometimes, they might wake up at 3 AM and turn off their machine after only 3.5 hours of use. 

Yes, it’s true. Sometimes, wearing a mask connected to the CPAP or BiPAP machine can be uncomfortable. 

It is worth investing in some of the accessories for the machine that can help you get a good night’s sleep. Finding the right face mask that I could wear comfortably while I slept took me a while. I also opted for equipment that would help keep the air the machine delivers nice and warm, especially in the winter. If you do find that you’re having trouble getting comfortable with your mask or machine— speak with your doctor, who can help you find the right settings or equipment to help restore your sleep.  

It’s worth it in the long run for your body and overall brain health.