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Expert Interview Sleep-related Breathing Disorders Sleep Apnea Increases Brain Amyloid Burden in the Early Preclinical Stages of Alzheimer’s Disease—A Potential New Therapeutic Target? An expert interview with Ricardo S Osorio Center for Brain Health, NYU Langone Medical Center, New York, NY, US Ricardo S Osorio Ricardo S Osorio is a Research Assistant Professor of Psychiatry at NYU Center for Brain Health (CBH). He completed his psychiatry residency training at the Hospital 12 de Octubre (Spain) and the UCL Institute of Neurology (UK), and worked as a geriatric psychiatrist at Complejo Hospitalario de Toledo (Spain) in its Memory Disorders Unit. Before coming to NYU, he also worked as a research scientist in the Alzheimer’s Project Research Unit (CIEN Foundation, Spain). At CBH, Dr. Osorio’s focal area of research interest was the use of neuroimaging and cerebrospinal fluid biomarkers to assist in the study of sleep disturbances as risk factors for cognitive impairment in aging and for dementia. Dr. Osorio also collaborates with researchers from the NYU Sleep Disorders Center and the NYU Center for Neural Science in the NYU Sleep, Aging, and Memory (SAM) Lab. The SAM Lab investigates why we sleep, what happens to the brain during sleep, and the consequences of disturbed sleep on the brain. Its mission is to solve these and other issues related to sleep, normal aging, memory processing, and the risk for Alzheimer’s disease. Keywords Obstructive sleep apnea, amyloid burden, cognitive impairment, Alzheimer’s disease Disclosure: Ricardo S Osorio has nothing to disclose in relation to this article. This is an expert interview and, as such, has not undergone the journal's standard peer review process. Authorship: All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published. Open Access: This article is published under the Creative Commons Attribution Noncommercial License, which permits any noncommercial use, distribution, adaptation, and reproduction provided the original author(s) and source are given appropriate credit. Received: November 20, 2017 Published Online: December 12, 2017 Citation: US Respiratory & Pulmonary Diseases, 2017;2(1):17–8 Corresponding Author: Ricardo S Osorio, Center for Brain Health, NYU Langone Medical Center, 145 E 32nd St, 5th Floor, New York, NY 10016, US. E: Support: No funding was received in the publication of this article. A lzheimer’s disease (AD), the most common type of dementia, afflicts approximately 5 million people in the US, and they tend to be over the age of 60 years. By 2050, this number is projected to increase by almost three-fold to 14 million people. 1 The prevalence of obstructive sleep apnea (OSA) is even higher. Depending on how OSA is defined, anywhere between 30–80% of the elderly, often unknowingly, have this sleep disorder. 2,3 In an expert interview, Richard S Osorio of NYU Center for Brain Health discusses important findings from their recent two-year longitudinal study that reveal huge clinical potential for developing better screening tools to diagnose OSA in the elderly. 4 Q: Could you tell us a little about the design of your recent study investigating obstructive sleep apnea (OSA) and the risk of Alzheimer's disease (AD)? We enrolled a group of 208 cognitively normal elderly people from the community without sleep complaints. The presence of OSA monitored at home and the risk for AD, defined as increased amyloid burden using cerebrospinal fluid (CSF) and amyloid positron emission tomography (PET), were both measured longitudinally over two years. The objective of the study was to assess whether an association exists between the severity of OSA and longitudinal increase in amyloid burden in cognitively normal elderly people. 4 Q: What was the prevalence of OSA among study participants? Among the 208 participants recruited at baseline, 97 were free of OSA and considered healthy controls, 76 had mild OSA (Apnea–Hypopnea Index with 4% desaturation limit [AHI 4% ] 5–15), and 35 had moderate-to-severe OSA (AHI 4% >15). A subset of this group was followed up longitudinally. 4 Q: What were the main findings of the study? At cross-section we found no associations, but over time (mean follow-up time was 2.5 years) there was an association between OSA severity at baseline and longitudinal increase in amyloid burden in both CSF and PET, without changes in cognition. 4 TOU CH MED ICA L MEDIA 17