Obstructive sleep apnea (OSA) is prevalent in the general population, with many cases undiagnosed, and it is also common among individuals with dementia, particularly those with Alzheimer’s disease (AD) and mild cognitive impairment (MCI). OSA is associated with factors that may exacerbate AD pathology, such as amyloid and tau accumulation. The standard treatment for OSA is continuous positive airway pressure (CPAP), which has shown potential benefits for cognition, although adherence to CPAP treatment remains low, especially among those with cognitive impairments.

A systematic review of CPAP adherence in individuals with OSA and comorbid MCI or AD revealed that adherence rates are low but comparable to those seen in the general older population without cognitive impairment. The authors emphasized the importance of not excluding individuals with cognitive impairment from CPAP treatment, given its potential to improve brain health and slow the progression of dementia-related pathology. Future research should focus on optimizing CPAP adherence through interventions such as telemedicine and examining the long-term effects of CPAP on cognitive outcomes in this population.

Reference: Oliver C, Li H, Biswas B,. A systematic review on adherence to continuous positive airway pressure (CPAP) treatment for obstructive sleep apnoea (OSA) in individuals with mild cognitive impairment and Alzheimer’s disease dementia. Sleep Med Rev. 2024;73:101869. doi: 10.1016/j.smrv.2023.101869.