Continuous positive airway pressure deepens sleep in patients with Alzheimer’s disease and obstructive sleep apnea☆
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).
Conclusion
In mild to moderate AD patients with OSA, the use of tCPAP resulted in deeper sleep after just one night, with improvements maintained for 3weeks.
ABSTRACT