Increases In TST Related To CPAP Treatment Improve Cognition In Alzheimer Patients With OSA

Main Category: Alzheimer's / Dementia
Also Included In: Sleep / Sleep Disorders / Insomnia;  Respiratory / Asthma;  Conferences
Article Date: 11 Jun 2008 - 8:00 PST

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Increases in total sleep time related to the treatment of obstructive sleep apnea (OSA) with continuous positive airway pressure (CPAP) are associated with improvements in cognition in patients with Alzheimer disease, according to a research abstract presented on Tuesday at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS).

The study, authored by Jana R. Cooke, MD, Sonia Ancoli-Israel, PhD and colleagues from the University of California San Diego, focused on 52 participants with an average age of 77.8 years who had Alzheimer disease and OSA. The participants were randomized to six weeks of therapeutic CPAP or three weeks placebo CPAP followed by three weeks therapeutic CPAP. The participants underwent cognitive testing at baseline, three weeks and six weeks. Sleep was analyzed and scored for sleep stage, total sleep time, amount of time awake during the night, and the amount of oxygen in the blood.

According to the results, when Alzheimer's disease patients with OSA were treated with CPAP, an increase in the total amount of sleep at night, not improvement in oxygen levels, was associated with improvements in cognition.

"This finding implies that the cognitive dysfunction associated with OSA in patients with dementia may be in part an effect of short sleep time rather than a function of low levels of oxygen during sleep," said Dr. Cooke.

OSA is a sleep-related breathing disorder that causes your body to stop breathing during sleep. OSA occurs when the tissue in the back of the throat collapses and blocks the airway. This keeps air from getting into the lungs. OSA is more common among older adults and among people who are significantly overweight. OSA can increase a person's risk for high blood pressure, strokes, heart disease, and cognitive problems.

Not sleeping well can lead to a number of problems. Older adults who have poor nighttime sleep are more likely to have a depressed mood, attention and memory problems, excessive daytime sleepiness, more nighttime falls and use more over-the-counter or prescription sleep aids. In addition, recent studies associate lack of sleep with serious health problems such as an increased risk of obesity, cardiovascular disease and diabetes.

While most people require seven to eight hours of sleep a night to perform optimally the next day, older adults might find this harder to obtain. Older adults must be more aware of their sleep and maintain good sleep hygiene by following these tips:

• Establishing a routine sleep schedule.
  
  
• Avoiding utilizing bed for activities other than sleep or intimacy.
  
  
• Avoiding substances that disturb your sleep, like alcohol or caffeine.
  
  
• Not napping during the day. If you must snooze, limit the time to less than one hour and no later than 3 p.m.
  
  
• Stick to rituals that help you relax each night before bed. This can include such things as a warm bath, a light snack or a few minutes of reading.
  
  
• Don't take your worries to bed. Bedtime is a time to relax, not to hash out the stresses of the day.
  
  
• If you can't fall asleep, leave your bedroom and engage in a quiet activity. Return to bed only when you are tired.
  
  
• Keep your bedroom dark, quiet and a little cool.

First introduced as a treatment option for sleep apnea in 1981, CPAP is the most common and effective treatment for OSA. CPAP provides a steady stream of pressurized air to patients through a mask that they wear during sleep. This airflow keeps the airway open, preventing the pauses in breathing that characterize sleep apnea and restoring normal oxygen levels.

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CPAP Central (www.SleepEducation.com/CPAPCentral), a Web site created by the AASM, provides the public with comprehensive, accurate and reliable information about CPAP. CPAP Central includes expanded information about OSA and CPAP, including how OSA is diagnosed, the function of CPAP, the benefits of CPAP and an overview of what to expect when beginning CPAP, the position of experts on CPAP, and tools for success. CPAP Central also features an interactive slide set that educates the public about the warning signs of OSA.

Although sleep patterns change as people age, disturbed sleep and waking up tired every day are not part of normal aging. Those who have trouble sleeping are advised to see a sleep specialist at a facility accredited by the AASM.

More information about "sleep and growing older" is available from the AASM at http://www.sleepeducation.com/Topic.aspx?id=30, and OSA at http://www.sleepeducation.com/Disorder.aspx?id=7.

The annual SLEEP meeting (9-12 June, 2008) brings together an international body of 5,000 leading researchers and clinicians in the field of sleep medicine to present and discuss new findings and medical developments related to sleep and sleep disorders.

More than 1,000 research abstracts will be presented at the SLEEP meeting, a joint venture of the AASM and the Sleep Research Society. The three-and-a-half-day scientific meeting will bring to light new findings that enhance the understanding of the processes of sleep and aid the diagnosis and treatment of sleep disorders such as insomnia, narcolepsy and sleep apnea.

SleepEducation.com, a patient education Web site created by the AASM, provides information about various sleep disorders, the forms of treatment available, recent news on the topic of sleep, sleep studies that have been conducted and a listing of sleep facilities.

Source: Kathleen McCann
American Academy of Sleep Medicine

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