CPAP for Obstructive Sleep Apnea: Impact on Cognition

In a recent study, published in Sleep Medicine, researchers sought to characterize the impact of continuous positive airway pressure (CPAP) therapy on cognitive impairment due to neurodegenerative or vascular etiologies in patients with obstructive sleep apnea (OSA). Based on their results, the study’s authors suggested that use of CPAP was associated with improved cognitive outcomes.

This retrospective study analyzed 171 patients (mean years of age, 69.8 ± 10.6; 66% male) with cognitive impairment and a diagnosis of OSA confirmed with polysomnography or home sleep apnea testing. Researchers reviewed Epworth Sleepiness Score (ESS), Montreal cognitive Assessment (MoCA), and Mini-Mental Status Examination (MMSE) before and after CPAP initiation.

CPAP Adherence May Improve Cognitive Outcomes in OSA

Good CPAP adherence during follow-up was defined as use of CPAP for ≥4 hours per night for 7 days each week, and multivariate linear mixed-effects models were used to define associations between CPAP adherence and cognitive outcomes.

After adjusting for age, sex, body mass index, baseline ESS, duration of CPAP therapy, relevant comorbidities, and effects of research cohort subjects, researchers calculated that good CPAP adherence for 2-12 months during follow-up was associated with a 2.3-point increase in MoCA score (95% CI, 1.2-3.3; P<.001) and a 1.2-point increase in MMSE score (95% CI, 0.3-2.3; P=.01) compared with baseline. The report did note that severity of a patient’s cognitive impairment may effect CPAP’s association with cognitive outcomes.

Overall, the study’s findings indicated a potential cognitive benefit with CPAP adherence in patients with OSA, and the authors suggested “the findings of this study may aid in motivating patients to use CPAP and support future randomized controlled trials in this area.”

Related: Screening for Obstructive Sleep Apnea