Links Between OSA and White Matter Hyperintensities Common in Brain Aging

Sleeping man, OSA
Sleeping man, OSA
Researchers explored the relationship between OSA and white matter hyperintensities, which are associated with brain aging and dementia.

A polysomnography-based study involving patients with obstructive sleep apnea (OSA) found that both the apnea-hypopnea index and the oxygen desaturation index were associated with brain white matter hyperintensities (WMHs). Study results were recently published in JAMA Network Open.

In a general population–based, cross-sectional, observational study, researchers evaluated apnea-hypopnea index and oxygen desaturation index during a single-night, laboratory-based polysomnography measurement. Associations were then examined between these common sleep apnea markers and brain WMHs data automatically segmented from 1.5-T magnetic resonance images.

Among the 529 study participants who underwent polysomnography testing, the mean age was 52.15 years and 53% of the population was female. A diagnosis of OSA was made according to apnea-hypopnea index criteria in 209 study participants and in 102 study participants according to oxygen desaturation index criteria. Both the apnea-hypopnea index and oxygen desaturation index were significantly associated with brain WMH volumes. This difference remained significant even after accounting for vascular, metabolic, and lifestyle risk factors.

The study authors wrote, “These analyses found significant associations between OSA, diagnosed by [polysomnography], and brain WMHs in a large-scale, general population study.” They added, “Future studies might investigate the effect of OSA on WMH burden in specific OSA populations and the effect of OSA treatments on WMH burden in longitudinal clinical trials.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Zacharias HU, Weihs A, Habes M, et al. Association between obstructive sleep apnea and brain white matter hyperintensities in a population-based cohort in Germany. JAMA Netw Open. 2021;4(10):e2128225. doi:10.1001/jamanetworkopen.2021.28225