The Association Between Sleep Apnea Severity and ARIA in People with Alzheimer’s Patients Treated with Anti-amyloid Therapy
Caitlyn Kirshy1, Alice Bubel1, Zainab Raza1, Joanna Weller1, Matthew Jo1, Cassidy Fitchett1, Barbara Bumstead1, Danielle Walthers1, Kelly Yip1, Anil Mattoo1, Hrayr Pierre Attarian2, Myassar Zarif1, Mark Gudesblatt1
1NYU Grossman Long Island School of Medicine, 2Northwestern University
Objective:
To explore the relationship between sleep apnea and ARIA development in patients with Alzheimer's disease (PwAD) treated with Lecanemab
Background:
Amyloid-related imaging abnormalities (ARIA) are a known complication of anti-amyloid therapies used in the treatment of PwAD. Various predictors of ARIA risk have been investigated: medical comorbidities, medication use, and genetic factors. Sleep disturbance metrics have not been as thoroughly explored in this context as a factor in the development of ARIA. This study aims to examine the relationship between ARIA status and sleep parameters in patients undergoing Lecanemab treatment.
Design/Methods:
A retrospective analysis was conducted on 26 PwAD (72.5 years ± 6.25) treated with Lecanemab who had documented ARIA status via MRI and available sleep study data, including predicted Apnea-Hypopnea Index (pAHI), REM sleep percentage, and total sleep percentage. Mann-Whitney U tests were performed in view of the small sample size to compare REM/total sleep percentage and pAHI between ARIA-positive and ARIA-negative patients.
Results:
Of the 26 PwAD analyzed, 9 (34.6%) developed ARIA. Each subgroup analysis included 20 PwAD with valid ARIA status and corresponding sleep metric data. The Mann-Whitney U test demonstrated a statistically significant difference in pAHI scores between ARIA-positive and ARIA-negative patients (U = 9, p = 0.0286), indicating a higher sleep-disordered breathing severity in the ARIA-positive group. No significant differences were observed in REM sleep percentage (p = 0.243) or total sleep percentage (p = 0.682) between the groups.
Conclusions:
These preliminary findings suggest a potential association between increased sleep-disordered breathing severity and ARIA development in people with Alzheimer’s Disease treated with Lecanemab. While no significant differences were found for %REM or total sleep percentages, the significant Mann-Whitney U result for pAHI warrants further investigation.
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