Continuous positive airway pressure deepens sleep in patients with Alzheimer’s disease and obstructive sleep apnea

Cooke, Jana R.; Ancoli-Israel, Sonia; Liu, Lianqi; Loredo, Jose S.; Natarajan, Loki; Palmer, Barton S.; He, Feng; Corey-Bloom, Jody

doi:10.1016/j.sleep.2008.12.016

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Volume 10, Issue 10 , Pages 1101-1106, December 2009

Continuous positive airway pressure deepens sleep in patients with Alzheimer’s disease and obstructive sleep apnea☆

Jana R. Cooke
- Department of Medicine, University of California San Diego, USA
- Veterans Affairs San Diego Healthcare System, USA
Sonia Ancoli-Israel
- Department of Psychiatry, University of California San Diego, USA
- Corresponding author. Address: Department of Psychiatry, UCSD, 9500 Gilman Drive 0733, La Jolla, Ca 92093-0733, USA. Tel.: +1 858 822 7710; fax: +1 858 822 7712.
Lianqi Liu
- Department of Psychiatry, University of California San Diego, USA
Jose S. Loredo
- Department of Medicine, University of California San Diego, USA
- Veterans Affairs San Diego Healthcare System, USA
Loki Natarajan
- Department of Family and Preventative Medicine, University of California, San Diego, USA
Barton S. Palmer
- Department of Psychiatry, University of California San Diego, USA
Feng He
- Department of Family and Preventative Medicine, University of California, San Diego, USA
Jody Corey-Bloom
- Veterans Affairs San Diego Healthcare System, USA
- Department of Neurosciences, University of California San Diego, USA

Received 17 July 2008; received in revised form 11 November 2008; accepted 22 December 2008.

Abstract

Objective

Patients with Alzheimer’s disease (AD) and obstructive sleep apnea (OSA) experience disrupted sleep. This study examined the effect of continuous positive airway pressure (CPAP) on sleep parameters in AD patients with OSA.

Methods

A randomized placebo-controlled trial of 3weeks of therapeutic CPAP (tCPAP) vs. 3weeks placebo CPAP (pCPAP) followed by 3weeks tCPAP in patients with AD and OSA. Polysomnography data from screening after one night and after 3weeks of treatment were analyzed. Records were scored for percent of each sleep stage, total sleep time (TST), sleep efficiency (SE), sleep period (SP), time in bed (TIB), sleep onset (SO), wake time after sleep onset (WASO), and arousals. A randomized design comparing one night of pCPAP to tCPAP and a paired analysis combining 3weeks of tCPAP were performed.

Results

Fifty-two participants (mean age=77.8years, SD=7.3) with AD and OSA were included. After one treatment night, the tCPAP group had significantly less % Stage 1 (p=0.04) and more % Stage 2 sleep (p=0.02) when compared to the pCPAP group. In the paired analysis, 3 weeks of tCPAP resulted in significant decreases in WASO (p=0.005), % Stage 1 (p=0.001), arousals (p=0.005), and an increase in % Stage 3 (p=0.006).