OSA and Parkinson’s: New Findings from Veterans Study

A new study published in the Journal of the American Medical Association links Obstructive Sleep Apnea (OSA) with an increased risk of Parkinson’s disease, based on research involving more than 11 million military veterans. The data came from patients’ electronic health records (EHRs) provided by the U.S. Department of Veterans Affairs (VA) health system spanning from 1999 to 2022. Researchers analyzed medical histories and health information, looking for common patterns. These included doctor visits, lab results, medications, and diagnoses over months or years. 

The study consisted of U.S. veterans, 90% of whom were male and 9.8% female, and at least 60 years of age or older. Of those veterans, about 13.7% percent had Obstructive Sleep Apnea.

According to the study, veterans who were diagnosed with OSA were more likely to develop Parkinson’s than those without OSA. The study indicates that the risks of Parkinson’s appeared two years after the diagnosis, with the risk continuing to grow the longer the patient’s health was tracked, meaning the connection to both OSA and Parkinson’s disease isn’t a fluke. The risk of Parkinson’s disease started early and kept getting stronger over time. 

How Parkinson’s Affects Breathing

Parkinson’s disease can impact a patient’s breathing in multiple ways. It may stiffen and slow the respiratory muscles, leading to a sensation of not being able to take a deep breath and resulting in shortness of breath or shallow breaths. Additionally, it can cause upper airway dysfunction, which may produce noisy breathing or difficulty coordinating breathing with swallowing. These changes in respiratory response due to Parkinson’s are responsible for issues such as Obstructive sleep apnea and disrupted sleep patterns like REM sleep behavior disorder. 

Researchers describe several biological mechanisms through which obstructive sleep apnea could worsen or accelerate Parkinson’s-related brain changes. Prolonged time spent lying on the back, upper airway dysfunction caused by early rigidity, frequent sleep fragmentation from repeated breathing interruptions, and abnormal brainstem control of breathing can all contribute to a cycle of low oxygen levels, increased brain inflammation, and heightened stress on dopamine-producing neurons. Together, these factors may meaningfully elevate the risk of developing Parkinson’s disease.

Continuous Positive Airway Pressure

The study points to the use of CPAP, which lowered the risk of Parkinson’s The study indicates that using CPAP reduced the risk of Parkinson’s when therapy was initiated within two years of an OSA diagnosis. Researchers tracked CPAP usage using prescription orders, equipment records, clinical notes, and other indicators derived from the available medical data. What the study found is that those patients diagnosed with OSA who used CPAP machines had a 31% lower risk of getting Parkinson’s compared to people with OSA who didn’t use CPAP. The study estimated that for every 439 people with OSA who start CPAP promptly, 1 case of Parkinson’s could be prevented within 5 years. Previous research shows that the use of CPAP improves oxygen flow, normalizes sleep, reduces inflammation, and helps restore the brain’s ability to “clean itself.”

This study of U.S. veterans found that those with sleep apnea who used CPAP early on had a notably reduced risk of developing Parkinson’s disease years later. CPAP not only enhanced sleep quality but also seemed to offer brain protection.

The full study can be found here at JAMA Neurology.

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