The association of sleep-disordered breathing with high cerebral pulsatility might not be related to diffuse small vessel disease. A pilot study

Abstract

Background In a population-based sampling study conducted in community-dwelling older adults living in rural Ecuador, we aimed to assess the relation among sleep-disordered breathing, cerebral pulsatility index, and diffuse small vessel disease. MethodsOf 25 participants, 9 (36 %) had moderate-to-severe sleep-disordered breathing, characterized by an apnea/hypopnea index ≥15 per hour, and 10 (40 %) had moderate-to-severe white matter hyperintensities, graded according to the modified Fazekas scale. Mean (SD) pulsatility index in the middle cerebral artery was 1.18 (0.19) and positively correlated with the apnea/hypopnea index (R = .445, P = .03, [Pearson’s correlation coefficient]). The middle cerebral artery pulsatility index was increased in persons with moderate-to-severe sleep-disordered breathing compared with persons who had none-to-mild sleep-disordered breathing (mean [SD] 1.11 [0.12] vs. 1.3 [0.23], P = .01). No significant differences were found in the prevalence of moderate-to-severe white matter hyperintensities across groups of sleep-disordered breathing (P = .40) or in the mean apnea/hypopnea index across groups of persons with none-to-mild or moderate-to-severe white matter hyperintensities (P = .16). ConclusionsThis pilot study shows that moderate-to-severe sleep-disordered breathing correlates with cerebral pulsatility, but such association might be independent of diffuse small vessel disease.

Cerebral white matter diffusion properties and free‐water with obstructive sleep apnea severity in older adults

“…Moreover, we did not observe more white matter hyperintensities in OSA groups. Previous studies reported either more white matter hyperintensities (Baik, Seo, Yoon, Kim, & Shin, ; Del Brutto, Mera, Zambrano, & Castillo, ; Kim et al, ; Song et al, ) or no changes in OSA (Castillo, Del Brutto, Andrade Mde, Zambrano, & Nader, ; Lutsey et al, ; Schulz et al, ). Increased diffusivity is reported in individuals with a high white matter hyperintensities load (Svard et al, ), which might explain why our sample characterized by lower white matter water diffusivities did not present more white matter hyperintensities.…”