Continuous Positive Airway Pressure Treatment in patients with Alzheimer's disease: a systematic review

Abstract

Epidemiological studies have suggested a pathophysiological relationshipbetween obstructive sleep apnea syndrome (OSAS) and Alzheimer’s disease (AD). The aim of thisstudy is to evaluate the treatment of obstructive sleep apnea with continuous positive airway pressure(CPAP) in AD and its relationship with neurocognitive function improvement. Methods: Systematicreview conducted following PRISMA’s statements. Relevant studies were searched in MEDLINE,PEDro, SCOPUS, PsycINFO, Web of Science, CINAHL and SportDicus. Original studies in whichCPAP treatment was developel in AD patients have been included. Results: 5 studies, 3 RCTs(Randomized controlled trials) and 2 pilot studies. In all RCTs the CPAP intervention was six weeks;3 weeks of therapeutic CPAP vs. 3 weeks placebo CPAP (pCPAP) followed by 3 weeks tCPAPin patients with AD and OSA. The two pilot studies conducted a follow-up in which the impacton cognitive impairment was measured. Conclusions: CPAP treatment in AD patients decreasesexcessive daytime sleepiness and improves sleep quality. There are indications that cognitivedeterioration function measured with the Mini Mental Scale decreases or evolves to a lesser extent inAlzheimer ’s patients treated with CPAP. Caregivers observe stabilization in disease progression withintegration of CPAP. More research is needed on the topic presented