New research shows that older women with both insomnia and sleep apnea are at higher risk of memory decline. The findings could lead to improved screening and treatment for these comorbid conditions.
A new study has found that older women who suffer from both insomnia and sleep apnea, a condition known as COMISA, demonstrate significantly worse verbal memory performance compared to their peers who only have sleep apnea. The findings highlight a sex-specific vulnerability that could have crucial implications for cognitive health in older women.
Published in the Journal of Clinical Sleep Medicine, the study involved 110 older adults between the ages of 65 and 83, all diagnosed with obstructive sleep apnea. Participants underwent an overnight sleep study and cognitive testing, with validated tools used to assess insomnia and verbal memory. About 37% of the participants were identified as having COMISA.
“We expected that having both insomnia and sleep apnea would worsen memory for everyone, but only older women showed this vulnerability. That was striking, especially because women typically outperform men on verbal memory tasks,” lead author Breanna Holloway, who holds a doctorate in clinical psychology and behavioral medicine and serves as a postdoctoral researcher at UC San Diego School of Medicine, said in a news release.
This significant discovery hints at a hidden, sleep-related pathway to cognitive decline in older women, a demographic already known for a higher incidence of Alzheimer’s disease when sleep apnea is untreated. The interaction between insomnia and sleep apnea remained significant even when adjusted for variables such as age, body mass index, sleep apnea severity and education.
The researchers attribute these findings to differences in sleep architecture between sexes. Post hoc analyses revealed that women with COMISA had more slow-wave sleep but less rapid eye movement (REM) sleep compared to men, emphasizing the necessity of considering sex-specific patterns when evaluating COMISA.
“These results point to an overlooked risk in women with both insomnia and sleep apnea,” Holloway added. “Because women are more likely to have insomnia and often go undiagnosed for sleep apnea, recognizing and treating COMISA early could help protect memory and reduce dementia risk.”