{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T01:23:17Z","timestamp":1785460997952,"version":"3.56.0"},"reference-count":41,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n The association of obstructive sleep apnea (OSA) with risk of incident cerebral microbleeds (CMBs) is unknown.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate the association between OSA severity and risk of incident CMBs in the late middle-aged general population.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cohort study included eligible participants who had in-home overnight polysomnography data and brain magnetic resonance imaging done at baseline (2011-2014) and 4-year follow-ups (first follow-up, 2015-2018, and second follow-up, 2019-2022) from an ongoing longitudinal cohort study of a Korean community of adults. Data were analyzed from March 2024 through January 2025.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n OSA severity was categorized by apnea-hypopnea index levels as no OSA (0-4.9 events\/h), mild OSA (5.0-14.9 events\/h), and moderate to severe OSA (\u226515.0 events\/h).<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n CMBs were defined as well-defined focal areas (&amp;lt;10 mm in diameter) of very low signal intensity on gradient echo T2*-weighted images. Modified Poisson regression (robust error variance) was used to estimate relative risk (RR), with 95% CIs, of incident CMBs by OSA group; adjustment was done for age, sex, education level, body mass index, physical activity level, smoking and drinking status, total and low-density lipoprotein cholesterol level, hypertension, diabetes, age-related white matter changes, change in apnea-hypopnea index level, change in body mass index, and mean arterial pressure of the corresponding follow-up.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 1441 study participants (mean [SD] age, 57.75 [5.53] years; 759 female [52.67%]), 436 participants (30.25%) and 193 participants (13.39%) had mild and moderate to severe OSA at baseline, respectively; 812 participants had no OSA. The cumulative incidence rate of CMBs in non-OSA, mild OSA, and moderate to severe OSA groups was 15 participants (1.85%), 7 participants (1.61%), and 9 participants (4.66%), respectively, at 4 years and 27 participants (3.33%), 14 participants (3.21%), and 14 participants (7.25%), respectively, at 8 years. In multivariable modified Poisson models, participants with moderate to severe OSA compared with the non-OSA group had an increased risk of developing CMBs at 8 years (RR, 2.14; 95% CI, 1.08-4.23;\n P<\/jats:italic>\n \u2009=\u2009.02). These results were unaffected by the presence or absence of\n APOE-\u03b54<\/jats:italic>\n carrier status. No significantly increased risks were observed at 4 years or in the mild OSA group at any time.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this study, moderate to severe OSA was independently associated with an increased risk of incident CMBs over an 8-year follow-up. These results add to the evidence for the importance of sleep apnea to brain health.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.39874","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T15:01:21Z","timestamp":1761663681000},"page":"e2539874","source":"Crossref","is-referenced-by-count":3,"title":["Obstructive Sleep Apnea and Cerebral Microbleeds in Middle-Aged and Older Adults"],"prefix":"10.1001","volume":"8","author":[{"given":"Ali Tanweer","family":"Siddiquee","sequence":"first","affiliation":[{"name":"Institute of Human Genomic Study, College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoon Ho","family":"Hwang","sequence":"additional","affiliation":[{"name":"Institute of Human Genomic Study, College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soriul","family":"Kim","sequence":"additional","affiliation":[{"name":"Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea"},{"name":"Department of Paramedicine, Seowon University, Cheongju, Chungbuk, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Ku","family":"Lee","sequence":"additional","affiliation":[{"name":"Institute of Human Genomic Study, College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min-Hee","family":"Lee","sequence":"additional","affiliation":[{"name":"Institute of Human Genomic Study, College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyeon Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea"},{"name":"Department of Neurology, Asan Medical Center, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Genome Research, Center for Genome Science, National Institute of Health, Chung cheong buk-do, 28159, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bong-Jo","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Genome Research, Center for Genome Science, National Institute of Health, Chung cheong buk-do, 28159, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter N.","family":"Hadar","sequence":"additional","affiliation":[{"name":"Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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