If you suffer from obstructive sleep apnea, you may be among the very many people who would rather endure it and its health consequences, such as heart disease, than use a noisy and uncomfortable continuous positive airway pressure (CPAP) machine while you sleep. About 25% of people with sleep apnea refuse to use CPAP. And of those who do use it, only 30% to 60% use their machines enough to be considered adherent (that is, cooperative about therapy) by their doctors. And adherent, as far as CPAP goes, is use for at least four hours a night for at least seven out of every 10 nights.

But now, the time for “blowing off” your CPAP machine has truly passed, because the results of a new study show something chilling: People who don’t consistently use their CPAP machines are damaging their brains. That’s right—if you don’t use CPAP enough, it could be costing you your ability to think and your memory.

Here’s why that happens…and how you can recover your lost brain function…

DIRE EFFECT OF SLEEP APNEA

The study was small but well-designed. It included 32 men who were in the prime of life (average age 43). Seventeen of them had severe sleep apnea but had never used CPAP…and 15 were healthy men who acted as controls. The researchers used MRI scans to study participants’ brains and, in particular, their white matter, which is the part of the brain that conducts nerve impulses and basically allows the different parts of the brain to communicate with each other. The men also took neuropsychological tests to evaluate their attention, reasoning, reaction times and long- and short-term memory.

The results, to put it mildly, were not good for the patients with sleep apnea. Neuropsychological tests taken before CPAP treatment began showed that the men with sleep apnea were simply not as sharp as the other men. Their thinking and reasoning were significantly slower and less accurate than the controls, and their short- and long-term memories were not as good. And the brain scans showed that the patients’ white matter was not intact—in other words, neural connections weren’t, in fact, connecting as efficiently as they should.

They had decided to delay treatment of their sleep apnea—and now their brains were disintegrating. But there was good news, too.

REGAIN YOUR BRAIN

The saving grace in this study was the following. In tracking the men’s functioning over time, researchers discovered that CPAP can reverse the damage to the brain’s white matter caused by sleep apnea. In fact, new white-matter connectedness began to be seen after only three months of regular CPAP use. After 12 months of use, a near complete reversal of white-matter damage in all of the affected parts of the brain was seen. This improvement in brain structure was reflected with improvement in memory, attention and other cognitive functions. In fact, scores on a series of neurocognitive tests matched nearly all the scores of the healthy controls. In short, CPAP virtually reversed brain damage caused by untreated sleep apnea.

In an earlier study, the same researchers found the same sort of results when they looked at how CPAP affected the brain’s gray matter. Gray matter controls muscle function and the senses.

The bottom line is that, if left untreated, sleep apnea can—no exaggeration—wreck your brain. CPAP therapy is very effective and can save your brain—but only if you use it. Alternatives such as an implantable device and wearable devices that force you to change sleep positions when you roll over onto your back (which can set off sleep apnea) are alternatives that do not work as well as CPAP but are better than no treatment at all. Also, new CPAP designs that are more comfortable and quieter are becoming available. Your doctor can also adjust the CPAP machine that you already have to make sure it fits comfortably. So, no more excuses…save your heart and your brain by doing what you can to manage your sleep apnea.