Treatment of sleep apnoea syndrome decreases cognitive decline in patients with Alzheimer's disease.
BACKGROUND
It is essential to detect and then treat factors that aggravate Alzheimer's disease (AD). Here, we sought to determine whether or not continuous positive airway pressure (CPAP) therapy for sleep apnoea syndrome (SAS) slows the rate of cognitive decline in mild-to-moderate AD patients.


METHODS
Between January 2003 and June 2011, we included consecutive, mild-to-moderate AD patients (a Mini Mental State Examination (MMSE) score at inclusion ≥15) with severe SAS as determined by video-polysomnography (an apnoea-hypopnoea index ≥30). In this single-blind, proof-of-concept trial, we analysed the mean decline in the annual MMSE score (the main outcome measure) according to whether or not the patients had received CPAP therapy. The decline was computed for each patient and for the first 3 years of follow-up.


RESULTS
Of the 23 included patients, 14 underwent CPAP treatment. The CPAP and non-CPAP groups did not differ significantly in terms of their demographic characteristics or MMSE score at baseline. The median annual MMSE decline was significantly slower in the CPAP group (-0.7 (-1.7; +0.8)) than in the non-CPAP group (-2.2 (-3.3; -1.9); p=0.013).


CONCLUSIONS
In this pilot study, CPAP treatment of severe SAS in mild-to-moderate AD patients was associated with significantly slower cognitive decline over a three-year follow-up period. Our results emphasise the importance of detecting and treating SAS in this population.
University Lille North of France, CHU, Lille, France EA 1046, Lille, France Memory Clinic, Lille, France.
Anne-Cécile
AC
Troussière
University Lille North of France, CHU, Lille, France EA 1046, Lille, France Department of Neurophysiology and Sleep Unit, Lille, France.
Christelle Monaca
CM
Charley
University Lille North of France, CHU, Lille, France Department of Public Health and Biostatistic Unit, Lille, France.
Julia
J
Salleron
University Lille North of France, CHU, Lille, France Department of Public Health and Biostatistic Unit, Lille, France INSERM UMR 744, Institut Pasteur, Lille, France.
Florence
F
Richard
University Lille North of France, CHU, Lille, France EA 1046, Lille, France Memory Clinic, Lille, France.
Xavier
X
Delbeuck
University Lille North of France, CHU, Lille, France EA 1046, Lille, France Department of Neurophysiology and Sleep Unit, Lille, France.
Philippe
P
Derambure
University Lille North of France, CHU, Lille, France EA 1046, Lille, France Memory Clinic, Lille, France.
Florence
F
Pasquier
University Lille North of France, CHU, Lille, France EA 1046, Lille, France Memory Clinic, Lille, France.
Stéphanie
S
Bombois
D000368:Aged; D000544:Alzheimer Disease / Q000150:complications*; D045422:Continuous Positive Airway Pressure; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D017286:Polysomnography; D016037:Single-Blind Method; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000628:therapy
Alzheimer's Disease; CSF; Cognition; Sleep Apnoea