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Sleep apnea changes the chemistry in the brain

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A study published in the USA in February of this year brings terrifying findings on the subject of obstructive sleep apnea, which at the same time give hope for new therapeutic approaches: sleep apnea changes the concentration of important chemical messengers in the brain. This disturbed brain chemistry could explain why many sleep apnea sufferers from concentration disorders, memory problems and depression and why they get stressed particularly easily. -by Marion Zerbst

Strong change in neurotransmitters

Scientists from the University of California examined the brains of 14 sleep apnea patients and 22 healthy people and were amazed when they found that the concentration of important chemical messengers (neurotransmitters) in a brain region in sleep apnea sufferers was greatly changed: The insula is among other things responsible for the regulation of our emotions and our thinking, but also for body functions such as blood pressure and perspiration. The sleep apnea sufferers had levels of the neurotransmitter GABA that were too low and glutamate levels that were too high in this region of the brain.

Possible damage to nerve cells

The abbreviation GABA stands for gamma-aminobutyric acid - a messenger substance that reduces the excitability of nerve cells, i.e. it has a calming, relaxing and anxiety-relieving effect. The sleep apnea patients had too little of that. On the other hand, they had too much of the messenger substance glutamate. Too high a concentration of this neurotransmitter leads to a kind of "permanent excitation": The brain works in stress mode and consequently does not work so well - concentration and memory disorders are the result. And not only that: high glutamate levels can also damage nerve cells.

Researchers are surprised

Earlier studies had already shown that sleep apnea leads to structural changes in the brain and that these are probably complicit in some typical OSA symptoms such as increased sweating, high blood pressure and cardiac arrhythmias. "But in this study we were actually able to demonstrate considerable differences in the concentration of two chemical messenger substances that influence the functioning of the brain," explained the head of the study, Dr. Paul Macey. This amazed the scientists: “We had expected an increased glutamate concentration because we know that this chemical substance damages the brain in high doses, and because brain damage due to sleep apnea had also been observed before. But the low GABA level really surprised us: It shows that sleep apnea does indeed seem to change the way the brain works. "

Increased risk of Alzheimer's dementia

The combination of excessively low GABA and excessively high glutamate levels could explain the decreased tolerance to stress, increased irritability and increased tendency to anxiety disorders and depression that many sleep apnea patients suffer from, according to the study's authors. And not only that: too high a glutamate level in the brain is also present in patients with Alzheimer's dementia. And it has been known for some time that sleep apnea also increases the risk of dementia. So here too there could be a connection.

light at the end of the tunnel

Nevertheless, Dr. In a way, Macey was even encouraged by the results of his investigation: “Once damage has occurred, it is usually irreparable. But a change in the way the brain works could perhaps be corrected. "

It is not yet known whether the disturbed neurotransmitter balance in the brain can be normalized again with CPAP therapy; The authors plan to carry out further studies on this in the future. But at least doctors now know what else they can do for a sleep apnea patient - in addition to prescribing a CPAP machine: "Stress, concentration disorders, memory loss - these are points that must be addressed in the treatment of such patients." It would be conceivable, for example, to treat the impaired brain chemistry with the help of drugs. But also in an indirect way - through behavioral changes - one could perhaps positively influence the neurotransmitters. For example, the team of scientists wants to investigate whether mindfulness exercises - which have a calming effect on the brain - can lower glutamate levels.

Source: Macey P, Sarma M, Nagarajan R, Aysola R, Siegel J, Harper R, et al. Obstructive sleep apnea is associated with low GABA and high glutamate in the insular cortex. The Journal of Sleep Research. 2016. DOI: 10.1111 / jsr.12392

Source: The sleep magazine issue 2/2016