Sorbonne University, CNRS, UMR Biological Adaptation and Aging, AP-HP, Paris, France; Charles-Foix Hospital, Functional Exploration Unit for Older Patients, 94200 Ivry-sur-Seine, France.
Rev Neurol (Paris). 2023 Oct;179(7):793-803. doi: 10.1016/j.neurol.2023.08.006. Epub 2023 Aug 24.
A growing number of studies, in animal models and humans, have highlighted the link between sleep and Alzheimer's disease (AD) pathophysiology. Among sleep disorders, obstructive sleep apnea (OSA) appears to be a potentially interesting comorbidity, as it is highly prevalent in the middle-aged and elderly population, often associated with some cognitive impairment, associated with an increased risk of developing cognitive decline and dementia including AD, and indeed treatable. The association between OSA and cognition varies according to the studies, but OSA is more frequent in older people with AD than those who are cognitively normal. People with OSA suffer from daytime sleepiness, impaired cognitive function and an increased risk of developing mild cognitive impairment, dementia and AD than those without OSA. Finally, the literature suggests a link between OSA and AD biomarkers. Whether screening and treating OSA could have positive impact on the levels of AD biomarkers and slow or even prevent incident dementia remain to be investigated. It therefore seems essential to understand the role of OSA in the pathophysiology of AD, as there is still no effective treatment to slow or halt its progression. At present, treating the risk factors that can promote the development and/or worsening of AD represents a promising strategy for delaying or even thwarting the onset of symptoms.
越来越多的研究在动物模型和人类中强调了睡眠与阿尔茨海默病（AD）病理生理学之间的联系。在睡眠障碍中，阻塞性睡眠呼吸暂停（OSA）似乎是一种潜在的有趣的合并症，因为它在中年和老年人中非常普遍，常与一些认知障碍相关，与认知能力下降和痴呆包括 AD 的风险增加相关，而且确实可以治疗。OSA 与认知之间的关联因研究而异，但在 AD 患者中，OSA 比认知正常者更为常见。与没有 OSA 的人相比，患有 OSA 的人白天嗜睡、认知功能受损，并且发生轻度认知障碍、痴呆和 AD 的风险增加。最后，文献表明 OSA 与 AD 生物标志物之间存在关联。筛查和治疗 OSA 是否可以对 AD 生物标志物水平产生积极影响，以及是否可以减缓或甚至预防痴呆的发生，仍有待研究。因此，了解 OSA 在 AD 病理生理学中的作用似乎至关重要，因为目前尚无有效的治疗方法可以减缓或阻止其进展。目前，治疗可能促进 AD 发展和/或恶化的危险因素代表了一种延迟甚至阻止症状出现的有前途的策略。
