Use of positive airway pressure in mild cognitive impairment to delay progression to dementia

Study Objectives: The aim was to assess the relationship between continuous positive airway pressure (CPAP) therapy and cognitive function in patients with mild cognitive impairment (MCI) and obstructive sleep apnea (OSA). Methods: This was a retrospective chart review of patients with MCI and OSA. CPAP therapy compliance was defined as average use of CPAP therapy for at least 4 hours per night. Kaplan-Meier estimates, log-rank tests, and Cox proportional hazards regression were done to compare the compliance groups in terms of progression to dementia, defined as a Clinical Dementia Rating of 1 or greater. Linear mixed models were used to assess the relationships between CPAP therapy compliance and neurological cognitive function outcomes over time. Results: Ninety-six patients were included with mean age at MCI diagnosis of 70.4 years, mean apnea-hypopnea index of 25.9 events/h, and mean duration of neurology follow-up of 2.8 years. Forty-two were CPAP compliant, 30 were noncompliant, and 24 had no CPAP use. No overall difference between the groups was detected for progression to dementia (P=.928, log-rank test). Patients with amnestic MCI had better CPAP use (P=.016) and shorter progression time to dementia (P = .042), but this difference was not significant after adjusting for age, education, and race (P = .32). Conclusions: CPAP use in patients with MCI and OSA was not associated with delay in progression to dementia or cognitive decline.