Obstructive sleep apnea syndrome and Alzheimer's disease pathology: may continuous positive airway pressure treatment delay cognitive deterioration?

Sleep Breath. 2021 Dec;25(4):2135-2139. doi: 10.1007/s11325-021-02320-4. Epub 2021 Feb 22.


Purpose: The main aim of the present study was to identify the long-term effects of continuous positive airway pressure (CPAP) treatment in patients co-affected by obstructive sleep apnea syndrome (OSAS) and mild cognitive impairment (MCI) or dementia due to Alzheimer's disease (ADD).

Methods: This retrospective multicentre study included patients affected by MCI or ADD, diagnosed according to the core clinical and biomarkers criteria, and presenting comorbid OSAS. Only patients performing at least a 1-year visit during their follow-up to monitor cognitive deterioration and adherence with CPAP treatment were included. Both Mini-Mental State Examination (MMSE) and clinical dementia rating scale (CDR) were conducted during the baseline and the follow-up visits.

Results: Twenty-four patients were included in the study and were distributed according to the diagnosis in MCI (n = 8) or ADD (n = 16). There were no significant differences in the variables analysed at baseline between the CPAP non-adherent and CPAP adherent patients. In the whole group, a significant decrease was found in MMSE scores, and a significant increase was found in CDR scores between baseline and follow-up. No longitudinal changes in ESS scores were statistically significant from baseline to follow-up. A significant difference was found for the mean score change of the CDR since CPAP non-adherent patients showed a higher mean change of CDR compared to CPAP adherent patients. No significant differences were found for the mean change of MMSE.

Conclusion: These findings highlight the clinical potential of treating OSAS with CPAP to delay cognitive deterioration in patients with MCI or ADD.

Keywords: Alzheimer’s disease; Continuous positive airway pressure treatment; Dementia; Mild cognitive impairment; Obstructive sleep apnea syndrome.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Alzheimer Disease / epidemiology
  • Alzheimer Disease / physiopathology
  • Alzheimer Disease / therapy*
  • Cognitive Dysfunction / epidemiology
  • Cognitive Dysfunction / therapy*
  • Comorbidity
  • Continuous Positive Airway Pressure*
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Retrospective Studies
  • Sleep Apnea, Obstructive / epidemiology
  • Sleep Apnea, Obstructive / therapy*