Apnea therapy may help cognition in Alzheimer’s

By Will Boggs, MD

NEW YORK (Reuters Health) - For patients with Alzheimer’s disease and obstructive sleep apnea, treatment with continuous positive airway pressure (CPAP) seems to improve cognitive function, according to a report in the Journal of the American Geriatrics Society.

“Do not hesitate to treat older demented (or non-demented) patients who have sleep apnea,” Dr. Sonia Ancoli-Israel told Reuters Health. “The decision for treatment should not be based on age.”

Obstructive sleep apnea occurs when airway passages become blocked during sleep, cutting off breathing for brief but frequent periods. Major symptoms include loud snoring and daytime sleepiness.

Continuous positive airway pressure is a device that delivers air through the airways using specially designed nasal masks or pillows. The air flow creates enough pressure to keep the airways open.

Ancoli-Israel and colleagues from the University of California San Diego, in La Jolla, studied 52 elderly patients with obstructive sleep apnea and mild-to-moderate Alzheimer’s disease. The subjects were randomly assigned to 6 weeks’ CPAP or 3 weeks’ sham treatment followed by therapeutic CPAP for another 3 weeks.

As expected, CPAP treatment significantly increased airflow, whereas placebo CPAP had no effect, the authors report. After 3 weeks of CPAP, significant improvements on individual portions of various standardized tests were seen.

CPAP was well tolerated and improved patients’ “sleep, their daytime sleepiness, and their cognition,” Ancoli-Israel said. “The caregivers also liked it and felt having the patient treated also improved their own sleep.”

“We are conducting a similar study now in Parkinson’s disease to examine the effect of CPAP treatment of sleep apnea on non-motor symptoms,” Ancoli-Israel added.

SOURCE: Journal of the American Geriatrics Society, November 2008.

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