Positive airway pressure may slow cognitive decline in adults with obstructive sleep apnea

Positive airway pressure therapy may delay cognitive decline in adults with obstructive sleep apnea, but more research is needed, according to a systematic review published in Neurology.

“Although recent work has identified [obstructive sleep apnea] as a potentially modifiable risk factor for cognitive decline and dementia, relationships between positive airway pressure therapy — the gold standard [obstructive sleep apnea] therapy — and neurocognitive disorders are poorly understood,” Monica Moon Shieu, PhD, MS, of the department of neurology’s division of sleep medicine at the University of Michigan, and colleagues wrote.

To better understand the impact of positive airway pressure (PAP) therapy on incidence of cognitive disorders and decline in middle-aged and older adults with obstructive sleep apnea (OSA), Shieu and colleagues searched MEDLINE, EMBASE, CINAHL and Scopus databases to identify 11 studies that highlighted associations between PAP therapy and subsequent cognitive disorders.

Results showed that within the 11 studies, 96% of participants (n = 60,840) had OSA while 5,826 had either mild cognitive impairment or Alzheimer’s disease. Among all participants, 43,973 received PAP therapy and 16,397 went untreated or were placed in a placebo group.

Researchers also found that the majority of studies revealed a slower rate of cognitive decline in those who utilized PAP therapy, with only two studies reporting no protective effects of PAP in delaying cognitive decline. However, data on the rate of decline in relation to PAP therapy remains mixed.

“Findings regarding the impact of PAP therapy on cognitive decline were promising, although larger studies with longer follow-up are warranted,” Shieu and colleagues wrote.