Hypertension and cognitive decline: Implications of obstructive sleep apnea

In the general population we see a significant amount of people with hypertension and dementia. Hypertension has been shown to be a risk factor for Alzheimer’s dementia and vascular dementia, but it is also strongly connected with obstructive sleep apnea. Recent evidence suggests that sleep apnea is linked with cognitive decline and dementia. 

This proves that it is possible that sleep apnea is the final common pathway linking hypertension to the development of dementia. And since sleep apnea is readily treatable, such therapy could potentially delay or prevent the onset of dementia. 

What are the connections?

Recently, hypertension has been recognized as a risk factor for cognitive decline and dementia. Both of these conditions are also commonly seen in the general population. However, a significant number of patients with hypertension remain untreated, which can increase their risk for developing long-term negative health consequences. 

Sleep disordered breathing, or sleep apnea, is also highly prevalent in the general population and is associated with several adverse cardiovascular outcomes. Sleep apnea has been linked to incident and prevalent hypertension in various studies. It is also thought that sympathetic overactivity leads to the development of high blood pressure in these individuals. It is possible that sleep apnea contributes to the increased risk of cognitive decline and dementia seen in those with hypertension. 

Treat patients with sleep apnea now

This means it is important as dentists to provide proper treatment for our patients with sleep apnea. Through oral appliance therapy, you can take the next step toward improving your patients’ overall health and well-being. 

For this reason it is extremely important to properly screen your patients each time they visit your office. In doing so, you may be the first to notice a problem. From there you can refer your patient to a sleep physician for further diagnosis and treatment planning. 

It is our duty as dentists to continue to provide for our patients, especially knowing the connections between sleep apnea and other conditions. 

Hypertension affects your patients’ whole body 

We know there are so many connections between certain conditions and sleep apnea. One condition is hypertension. As you know, it can have harmful effects on a person’s body if left untreated. However, did you know that sleep apnea shares the same exact risks as hypertension? By treating sleep apnea, it can potentially save your patients’ lives.

To help you share this important information with your patients, I have created an educational infographic below. 

Feel free to download this infographic and share it with your patients. The more they know, the better we can treat their condition and keep them healthy.

June is National Aphasia Awareness Month

The month of June is National Aphasia Awareness Month. This means, as dental sleep medicine specialists, we need to make sure our patients are staying on top of their health by treating sleep apnea and other symptoms in prevention of stroke. As you know, stroke is the number five cause of death and the leading cause of disability in the U.S. And a stroke can have a variety of communication effects, one of which is aphasia. Stroke is the most common cause of aphasia, which is a language disorder that affects the ability to communicate.

Raise Awareness for Aphasia

Let’s use June to help increase public education around this language disorder and to recognize the numerous people who are currently living with or caring for people with aphasia. The American Heart Association/American Stroke Association continues to increase awareness for aphasia by sharing communication tips, the effects of having aphasia, assistive devices for those with aphasia and more.

The Connection with Sleep Apnea

Heart disease is the leading cause of death for men and women. But what you may not realize is that sleep apnea can lead to heart attacks, which can cause people to die in the middle of the night due to low oxygen or the stress of waking up frequently during sleep.

The relationship between sleep apnea, hypertension, stroke and heart disease is very strong. It is vital that everyone understand this connection to further prevent the development of aphasia as well. Sleep apnea can be easily treated to prevent stroke, aphasia and other comorbidities. It is more important than ever to receive continuing education to further improve your patients’ well-being and health.

When patients receive up-to-date health care, you are taking preventative steps, but we still have a ways to go. Start today by educating your patients on the risks of untreated sleep apnea, stroke and aphasia.

Watch Out for Sleep Apnea with New Hypertension Guideline

Since the new hypertension guideline from the American College of Cardiology and the American Heart Association was released in November 2017, the way physicians diagnose and treat high blood pressure has changed. And with the new guideline comes a section on sleep apnea. Have you seen this new guideline yet?  

What does the guideline say?

The new guideline lowers the blood pressure cutoff for a hypertension diagnosis from 140/90 mm Hg to 130/80 mm Hg. And instead of using the term prehypertension, they recommend using stage 1 hypertension for levels of 130 to 139 mm Hg systolic or 80 to 89 mm Hg diastolic pressure and 120 to 129 mm Hg systolic and diastolic of less than 80 as “elevated.”

For obstructive sleep apnea, it is a risk factor for several cardiovascular diseases, including hypertension, coronary and cerebrovascular diseases. Studies have shown that the presence of OSA is associated with an increased risk of hypertension. It has also been hypothesized that treatment for sleep apnea will have more pronounced effects on BP reduction in resistant hypertension.

What does this mean for dentists?

This means we need to be extra cautious of our patients. Now that the level for hypertension has lowered, we need to pay attention to how that affects sleep apnea and vice versa. The guideline also recommends CPAP therapy as an effective form of treatment for improving sleep apnea, but studies that have been conducted showed that its effects on BP were only small.

Through the guideline, we can accept that CPAP therapy is an option, but what about oral appliance therapy? With the number of individuals with hypertension now at almost 50 percent, we need to pay closer attention to OSA and how it affects hypertension and high blood pressure.

Talk to your patients, include information on the health questionnaire and provide educational materials so that you can continue to provide your patients with the care they need and deserve. On top of that continue to complete advanced education to remain up-to-date with important information.