Effect of CPAP treatment on subjective cognitive decline in patients with mild obstructive sleep apnea syndrome

Liang Tan; Xin Zhang; Zhijian Fu; Chunyao Dong; Chang Zhou; Caiyun Hou; Yuanyuan Lin; Xiaolei Wang; Li Li; Jin Zhou

doi:10.1007/s41105-025-00620-w

Effect of CPAP treatment on subjective cognitive decline in patients with mild obstructive sleep apnea syndrome

Sleep Biol Rhythms. 2025 Nov 24;24(1):123-130. doi: 10.1007/s41105-025-00620-w. eCollection 2026 Jan.

Authors

Liang Tan^#¹, Xin Zhang^#¹, Zhijian Fu², Chunyao Dong¹, Chang Zhou¹, Caiyun Hou¹, Yuanyuan Lin¹, Xiaolei Wang¹, Li Li^#¹, Jin Zhou^#¹

Affiliations

¹ Department of Neurology, The first people's hospital of Shenyang, Shenyang, China.
² Department of Neurosurgery, The first people's hospital of Shenyang, Shenyang, China.

^# Contributed equally.

Abstract

There is no consensus on whether to use continuous positive airway pressure (CPAP) treatment for mild obstructive sleep apnea syndrome (OSAS). Our study aims to observe the efficacy and necessity of using CPAP treatment in mild OSAS patients complicated with subjective cognitive decline (SCD). From August 2021 to July 2022, patients with mild OSAS and SCD were randomized to the control group or the CPAP group, and followed up for 3 months. The primary results were evaluated using subjective cognitive decline questionnaire (SCD-Q), the Huashan version of the Auditory Verbal Learning Test (AVLT-H), and animal fluency test (AFT), which were tested at admission and three months after treatment, respectively. And plasma Aβ1-40 and Aβ1-42 levels were also measured at admission and 3 months after treatment. A total of 110 patients completed the final study, with 55 in the control group and 55 in the CPAP group. No significant differences in demographic data, Laboratory tests, AHI index, SCD-Q, AVLT-H, and AFT scores between the two groups before treatment. The SCD-Q score of patients in CPAP group significantly decreased after 3 months of treatment and was significantly lower than that of control group (P<0.05). And the immediate memory score of AVLT-H in the treatment group was significantly increased after 3 months of treatment (P < 0.05). The Aβ1-42/Aβ1-40 ratio in the treatment group significantly decreased after 3 months of treatment, and was significantly lower than that of control group (P<0.05). Furthermore, there was linear correlation between SCD-Q score and Aβ1-42/Aβ1-40 ratio in all patients after 3 months of treatment (P<0.001, r=0.584). Our findings suggested that CPAP treatment can significantly decrease the Aβ1-42/Aβ1-40 ratio, and improve SCD, which may play an important role in the prevention of dementia, but further research are warranted.

Supplementary information: The online version contains supplementary material available at 10.1007/s41105-025-00620-w.

Keywords: Continuous positive airway pressure; Aerobic exercise; Cognitive function; Obstructive sleep apnea syndrome; Subjective cognitive decline.