A NEW analysis suggests that obstructive sleep apnoea may increase the likelihood of receiving a Parkinson disease diagnosis, with early positive airway pressure treatment appearing to reduce that risk in a large cohort of US veterans.
Growing Evidence of Neurological Links in Obstructive Sleep Apnoea
Researchers have increasingly suspected that obstructive sleep apnoea influences long-term brain health, given its established association with dementia and premature mortality. Yet previous studies exploring the relationship between obstructive sleep apnoea and Parkinson disease have produced inconsistent findings. This new investigation focused on clarifying the connection while also evaluating whether continuous positive airway pressure therapy, the gold standard treatment for sleep disordered breathing, could modify risk.
Massive Veteran Cohort Reveals Higher Parkinson Incidence
This electronic health record-based cohort study reviewed data from 13,737,081 veterans, ultimately including 11,310, 411 individuals with a mean age 60.5 years for analysis. Of these, 1,552,505 (13.7 percent) had obstructive sleep apnoea. Follow up averaged 4.9 years. Veterans with obstructive sleep apnoea exhibited 1.61 additional Parkinson disease cases per 1000 people at six years from diagnosis (95 percent CI, 1.13 to 2.09) compared with those without obstructive sleep apnoea. The association persisted after adjusting for age, body mass index, vascular disease, psychiatric conditions, smoking status, and relevant medications. The effect was notably stronger in female veterans.
Crucially, early treatment with continuous positive airway pressure was linked to a significant reduction in Parkinson case numbers, highlighting its potential neuroprotective role. The findings held after balancing for demographic and clinical variables and adjusting for the competing risk of death.
Clinical Implications and Future Screening Practices
The results indicate that obstructive sleep apnoea may represent a modifiable midlife risk factor for Parkinson disease. Clinicians may need to prioritise robust screening protocols, early diagnosis and timely initiation of positive airway pressure therapy to preserve long term neurological function.
Reference
Neilson LE et al. Obstructive sleep apnea, positive airway pressure, and implications of early treatment in parkinson disease. JAMA Neurol. 2025;DOI:10.1001/jamaneurol.2025.4691.
