OSA Associated With Parkinson Disease Risk; Early CPAP Use May Reduce Onset

Obstructive sleep apnea (OSA) is associated with a significantly increased risk of developing Parkinson disease (PD); however, implementation of treatment with continuous positive airway pressure (CPAP) devices mitigates this risk successfully. These are the results of a study to be presented at the 2025 American Academy of Neurology (AAN) annual meeting, held from April 5 to 9, 2025, in San Diego, California.

In previous studies, researchers have found an association between OSA and various synucleinopathies, however, no studies have confirmed causal links between OSA and PD.

To determine whether OSA was a potential risk factor for PD, a team of researchers obtained data covering more than 20 years and over 20 million military veterans from the Veterans Association (VA) Corporate Data Warehouse (CDW). Using ICD-10 diagnosis codes, the researchers identified 1,552,505 military veterans with OSA and 9,759,246 veterans who did not have OSA.

Adjusting for various confounding factors, the researchers then analyzed the risk for PD incidence within 5 years after OSA diagnosis.

The researchers found an increased risk for PD incidence with 1.8 extra cases of PD per every 1000 people (95% CI, 1.4-2.3; P <.001) within 5 years of OSA onset.

The researchers further investigated the impact of OSA treatment on PD incidence. Individuals who started CPAP treatment “early” (within 2 years of OSA diagnosis) demonstrated lower incidence of PD within 5 years after OSA diagnosis with 2.3 fewer cases of PD per every 1000 people (P <.001).

Compared with individuals who initiated “early” CPAP treatment, those who started CPAP treatment “late” (more than 2 years after OSA diagnosis) demonstrated a similar rate of PD incidence to individuals who did not receive CPAP treatment for OSA. This finding suggests that CPAP treatment effectively helps to slow down the OSA-related neurodegenerative processes that promote PD development, but only when the treatment is initiated early enough.

“Results indicate that OSA may be an important, modifiable risk factor for the development of PD and other synucleinopathies,” the researchers concluded.