Brief Reports
Adherence to Continuous Positive Airway Pressure Treatment in Patients With Alzheimer Disease and Obstructive Sleep Apnea

https://doi.org/10.1097/01.JGP.0000192484.12684.cdGet rights and content

Objective

This analysis examined whether patients with Alzheimer disease (AD) tolerate continuous positive airway pressure (CPAP).

Method

Thirty patients with AD were randomized to CPAP or sham CPAP and completed sleep, depression, and quality-of-life questionnaires. Participants could choose to continue treatment after the trial.

Results

Patients wore CPAP for 4.8 hours per night. More depressive symptoms were associated with worse adherence (rS= −0.37; N = 30, p <0.04). Patients who continued using CPAP had fewer depressive symptoms (t [19] = 2.45, p = 0.02) and better adherence (t [19] = 2.32, p = 0.03) during the trial.

Conclusion

Patients with AD with obstructive sleep apnea can tolerate CPAP. Adherence and long-term use may be more difficult among those patients with more depressive symptoms.

Section snippets

Subjects

Thirty patients (23 male; 94% white; mean age: 78.4 years, standard deviation [SD]: 6.8, range: 53–91; mean body mass index: 24.7, SD: 3.7, range: 20.4–40.7; mean education: 14.8 years, SD: 3.1, range: 8–20) participated in a larger study evaluating the effect of CPAP on cognitive functioning in patients with mild-to-moderate AD and OSA. Patients were recruited from the University of California San Diego, CA (UCSD) Alzheimer's Disease Research Center (ADRC), advertisements, and referrals. All

RESULTS

DISCUSSION

To our knowledge, this is the first study to suggest that patients with AD who have OSA can use CPAP with reasonable adherence. Adherence with CPAP therapy in uncomplicated OSA has been marginal at best. It was surprising that the average number of hours of CPAP use per night in the patients with AD, 4.8 hours, was not very different from the number of hours reported in sleep disorders clinic patients.5 Because there can be beneficial effects of treating OSA on the cardiovascular system, mood,

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The authors acknowledge support from National Institue on Aging AG08415, National Institute of Mental Health 5 T32 MH18399-17, National Institute of Health General Clinical Research Center M01 RR00827, National Institute of Aging P50 AG05131, Veterans Affairs Health Services Research & Development Service 02-275, and the research service of the Veterans Affairs San Diego Healthcare System.

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