Investigating changes in cognition associated with the use of CPAP in cognitive impairment and dementia: A retrospective study

To characterize the impact of CPAP use on cognition in a clinical cohort with obstructive sleep apnea (OSA) and cognitive impairment due to neurodegenerative or vascular etiologies after controlling for baseline sleepiness. We retrospectively analyzed data from 171 patients with cognitive impairment...

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Bibliographic Details
Published in:Sleep medicine 2023-01, Vol.101, p.437-444
Main Authors: Costa, Yakdehikandage S., Lim, Andrew S.P., Thorpe, Kevin E., Colelli, David R., Mitchell, Sara, Masellis, Mario, Lam, Benjamin, Black, Sandra E., Boulos, Mark I.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Alzheimer's disease
Cognition
Cognitive Dysfunction - complications
Cognitive impairment
Continuous Positive Airway Pressure
CPAP
Dementia - complications
Female
Humans
Infant
Male
Middle Aged
Positive airway pressure
Retrospective Studies
Sleep apnea
Sleep Apnea, Obstructive - complications
Sleep Apnea, Obstructive - therapy
Sleepiness
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Summary:To characterize the impact of CPAP use on cognition in a clinical cohort with obstructive sleep apnea (OSA) and cognitive impairment due to neurodegenerative or vascular etiologies after controlling for baseline sleepiness. We retrospectively analyzed data from 171 patients with cognitive impairment and an OSA diagnosis confirmed with in-laboratory polysomnography or home sleep apnea testing (mean age 69.8 ± 10.6; 66% male) who were eligible to use CPAP. Baseline and follow-up Epworth Sleepiness Score (ESS), Montreal Cognitive Assessment (MoCA), and Mini-Mental Status Examination (MMSE) were obtained from clinical and research visits conducted before and after CPAP initiation. Good CPAP adherence was defined as CPAP use ≥4 h/night, for 7 days/week at follow-up. Associations between CPAP adherence and follow-up cognitive scores were analyzed using multivariable linear mixed-effects models. After adjusting for age, sex, body mass index, baseline ESS, duration of CPAP therapy, relevant comorbidities and the random effect of research study cohort, good CPAP adherence (compared to poor CPAP adherence or no use of CPAP) for a duration of 2–12 months was associated with a 2.3-point (1.2–3.3 95% CI) higher follow-up MoCA score (p 
ISSN:1389-9457
1878-5506
DOI:10.1016/j.sleep.2022.11.037