Gonzola Lambarca Trocios, MD: Precision Medicine in Obstructive Sleep Apnea

Author(s):

The goal is to address the desaturation drop in oxygen as well as well as treating the arousal effect in the brain, Dr. Lambarca Trocios says.

Groundbreaking data were presented at SLEEP 2023 in Indianapolis, IN, "Novel OSA-Driven Metric Predicts Incident Dementia in Sleep Apnea in 2 Different Community-Based Cohort Studies".

The MrOS study included 1136 patients with a median age of 76 years, while the MESA cohort included 1923 participants with a median age of 67 years. The MrOS cohort was 100% male and the MESA cohort was 46.3% male.¹

"We looked through other parameters, more related to the heart response, which is sometimes associated with the brain," Gonzalo Labarca Trucios, MD, instructor in medicine, Brigham and Women's Hospital, Harvard Medical School, said. "When we moved to the brain, we found if you have very high arousal intensity it's like your brain is on fire for a while."

In the MrOS portion of the study, the investigators, led by Labarca Trucios, found arousal events occurred in 11.4% of men in the study, with each 1 standard deviation increase in arousal intensity linked to a 23% higher risk of incident dementia (95% CI, 0 - 50; P <0.05).

For the MESA cohort, the team observed 3.5% of men experienced arousal events, with each increase in arousal intensity associated with a 29% increased risk of incident dementia (95% CI, 1-65; P <0.05).

"We know that with sleep apnea you have this lack of air, then you have either a desaturation drop in the oxygen, but also this arousal effect," he said. "So, if you treat both you can probably better identify and improve this complication."

References:

Trucios GL, Esmaeili N, Hu W, et al. 0830 Novel OSA-driven metric predicts incident dementia in sleep apnea in two different community-based cohort studies. SLEEP. 2023;46(Supplement_1):A365-A366.