Interrupted Sleep, Increased Risk: Untreated Sleep Apnea Doubles The Risk of Parkinson's Disease

People with obstructive sleep apnea have a higher chance of developing Parkinson's disease later in life. This risk persists even when other factors are considered, but it can be reduced when CPAP treatment is used early and correctly. This indicates that apnea may be a modifiable risk factor for protecting the brain against neurodegenerative diseases.

Obstructive sleep apnea is a condition in which breathing is repeatedly interrupted during sleep due to partial or total closure of the airways. This causes micro-awakenings and a drop in blood oxygen levels. Over time, this repetitive alteration generates stress on the brain and body, affecting cognitive, cardiovascular, and metabolic functions.

In recent years, research has begun to investigate whether this condition could be related to the development of neurodegenerative diseases, such as Parkinson's disease, which affects deep brain structures responsible for controlling movement, emotions, and sleep cycles.

This study analyzed medical records of over eleven million U.S. veterans over more than twenty years. These records allowed researchers to track both individuals with obstructive sleep apnea and those without the diagnosis, observing over time who developed Parkinson's disease.

This type of research, called a cohort study, is valuable because it allows for the observation of real patterns in a large and diverse population. The average age of the participants was around 60, a period in which age-related neuronal changes begin to be more evident.

The results showed that people with obstructive sleep apnea had a higher risk of developing Parkinson's disease over the follow-up period. Even when the study took into account additional factors that could influence the risk, such as age, weight, psychiatric conditions, cardiovascular disease, and medication use, the association remained significant.

This suggests that sleep apnea, in itself, may biologically contribute to processes affecting the brain. One important finding was that female veterans showed an even stronger association between sleep apnea and Parkinson's disease, indicating that hormonal factors or differences in brain physiology between men and women may influence this relationship.

Another key aspect of the research was the evaluation of the impact of CPAP treatment, a device that keeps the airways open during sleep through continuous positive airway pressure.

Participants who used CPAP early and consistently showed a significantly lower risk of developing Parkinson's disease. This suggests that the reduction in oxidative stress, inflammation, and sleep disruption caused by apnea may protect brain structures linked to movement, such as the substantia nigra, which produces dopamine. It is precisely the progressive loss of these dopaminergic cells that characterizes Parkinson's disease.

The overall conclusion of the study indicates that obstructive sleep apnea should not only be seen as an inconvenient condition linked to snoring and fatigue, but as a possible determining factor for serious neurological risks throughout life.

Furthermore, because it is a treatable condition, apnea may represent an important opportunity for the prevention of neurodegenerative diseases. Thus, diagnosing and treating this disorder early can generate positive long-term effects on brain health, especially in middle-aged adults.

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Obstructive Sleep Apnea, Positive Airway Pressure, and Implications of Early Treatment in Parkinson Disease

Lee E. Neilson, Isabella Montaño,  Jasmine L. May, Savanah Sicard, Yeilim Cho, Jeffrey J. Iliff, Jonathan E. Elliott, Miranda M. Lim, and Gregory D. Scott

JAMA Neurol, November 24, 2025

doi: 10.1001/jamaneurol.2025.4691

Abstract:

Obstructive sleep apnea (OSA) is associated with many health conditions, including dementia and early mortality. Prior epidemiological studies linking OSA with Parkinson disease (PD) are conflicting, and no studies have examined the influence of continuous positive airway pressure (CPAP), the criterion standard treatment for OSA, on PD risk. To examine the association between OSA with incident Parkinson disease among US veterans and risk modification by CPAP. This electronic health record (EHR)–based cohort study was conducted among US veterans from January 1, 1999, to December 30, 2022, with mean (SD) follow-up of 4.9 (1.8) years. Veterans with PD at the time of exposure or incomplete records were excluded. Data analysis was completed from September 2024 to September 2025. OSA was defined by its appropriate administrative code; CPAP usage was extracted from a semistructured medical interview field in the EHR. The primary outcome, cumulative incidence of PD, was calculated adjusting for competing risk of death after balancing for age, race, sex, and smoking status. A total of 13 737 081 US veterans were screened, and 11 310 411 veterans (1 109 543 female veterans [9.8%]) with mean (SD) age of 60.5 (14.7) years were included in analyses. Of included veterans, 1 552 505 (13.7%) had OSA. Veterans with OSA demonstrated 1.61 additional cases of PD (point estimate; 95% CI, 1.13-2.09) at 6 years from diagnosis per 1000 people compared to those without OSA. Results were confirmed when adjusting for body mass index, vascular comorbidities, psychiatric conditions, and relevant medications and were of greater magnitude in female veterans. Case numbers were significantly reduced when treated with CPAP early in the disease course. In this EHR-based cohort study, OSA appeared to be an independent risk factor for the later development of PD and could be modified by early treatment with CPAP. Effective screening measures and protocols for consistent adherence to CPAP may have large impacts on brain health.