Obstructive sleep apnea (OSA) was linked with an increased risk of Parkinson’s disease, but continuous positive airway pressure (CPAP) treatment reduced that risk, Veterans Administration (VA) data showed.
At 5 years after OSA onset, veterans with OSA had 1.8 more cases of Parkinson’s disease per 1,000 (95% CI 1.4-2.3, P<0.001) than those without the sleep disorder, said Gregory Scott, MD, PhD, of the VA Portland Health Care System in Oregon, and co-authors.
Of veterans with sleep apnea, 9.9% had documented use of a CPAP machine. Those who started CPAP early — within 2 years of OSA onset — had 2.3 fewer cases of Parkinson’s per 1,000 (P<0.001) compared with those who did not use CPAP, the researchers reported in an abstract released ahead of the American Academy of Neurology annual meeting.
Those who started CPAP later than 2 years after OSA onset had a similar risk of Parkinson’s disease as those who did not use CPAP at all.
“Obstructive sleep apnea is common and previous research has found when untreated, it is associated with an increased risk of heart attack and stroke,” Scott said in a statement. “While our study found an increased risk of Parkinson’s disease, the good news is people can do something about it by using CPAP as soon as they are diagnosed with the sleep disorder.”
Previous studies have linked OSA with various synucleinopathies, including Parkinson’s disease, the researchers noted. In a case-control study of outpatient insurance claims in Germany, a clinical diagnosis of sleep apnea was associated with a subsequent diagnosis of Parkinson’s.
Scott and co-authors used more than 20 years of VA records to study 1,552,505 veterans with OSA and 9,759,246 veterans without it.
Obstructive sleep apnea was defined by ICD-10 codes. Parkinson’s disease diagnoses were determined using two case definitions. CPAP use was determined using data from medical interviews. Findings were adjusted for inverted probability treatment weighting; age, sex, race, ethnicity, and other covariates; and competing risk of death.
“It is encouraging to know that while obstructive sleep apnea may increase the risk of Parkinson’s disease, treating it right away with CPAP may reduce that risk,” Scott noted. “Future studies are needed to follow people more closely after receiving a sleep apnea diagnosis and over longer periods of time.”
The study is observational and no causality can be established. In addition, the researchers were unable to tell whether people with OSA used CPAP treatment daily.
Disclosures
The study was supported by the U.S. Veterans Administration and the Department of Defense.
Primary Source
American Academy of Neurology
Source Reference: Montano I, et al “Obstructive sleep apnea is a risk factor for Parkinson’s disease and CPAP mitigates risk of PD: an EHR-based cohort study in military veterans” AAN 2025.
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