Treating obstructive sleep apnea may lower risk for dementia
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Positive airway pressure treatment was associated with a lower likelihood of incident Alzheimer’s disease and other types of dementia in older adults with obstructive sleep apnea, researchers reported.
“Although some evidence suggests a possible therapeutic benefit of positive airway pressure therapy on cognitive performance in older individuals, advancement of knowledge on this topic has been limited by use of small, single center or regional samples, heterogeneity in outcome measures and limited enrollment of older individuals,” Galit Levi Dunietz, PhD, MPH, assistant professor of neurology in the department of neurology and division of sleep medicine at the University of Michigan, Ann Arbor, and colleagues wrote in Sleep. “Furthermore, the role of OSA treatment in the development of specific neurodegenerative conditions such as Alzheimer’s disease — the most frequent cause of dementia in older adults — has not been sufficiently studied.”
Researchers at Michigan Medicine’s Sleep Disorders Center conducted a retrospective study of 53,321 Medicare beneficiaries (59% men; 90% non-Hispanic white) aged 65 years and older who were diagnosed with OSA before 2011. Participants were evaluated for neurocognitive syndromes newly identified from 2011 to 2013. Positive airway pressure (PAP) therapy adherence was defined as two or more Healthcare Common Procedure Coding System (HCPCS) codes for equipment separated by at least 1 month.
Seventy-eight percent of participants with OSA were prescribed PAP therapy, and 74% demonstrated evidence of adherence to PAP therapy.
PAP therapy was associated with lower odds for a diagnosis of incident Alzheimer’s disease (OR = 0.78; 95% CI, 0.69-0.89) and dementia not otherwise specified (OR = 0.69; 95% CI, 0.55-0.85) in adjusted models.
Researchers observed lower odds of mild cognitive impairment that approached statistical significance among those treated with PAP therapy (OR = 0.82; 95% CI, 0.66-1.02), according to the results.
Adherence to PAP therapy was also associated with lower odds for incident Alzheimer’s diagnoses (OR = 0.65; 95% CI, 0.56-0.76).
These findings stress the impact of sleep on cognitive function, according to the researchers.
“These population-based data highlight a potentially protective role for PAP therapy on short-term dementia risk in older adults with OSA,” the researchers wrote. “Additional research is necessary to explore mechanisms that may underlie this association; however, if a causal pathway exists, treatment of OSA may offer new opportunities to improve cognitive outcomes in older adults with OSA.”