Treatment of sleep apnoea syndrome decreases cognitive decline in patients with Alzheimer's disease

Troussière, Anne-Cécile; Charley, C. Monaca; Salleron, Julia; Richard, Florence; Delbeuck, Xavier; Derambure, Philippe; Pasquier, Florence; Bombois, Stéphanie

doi:10.1136/jnnp-2013-307544

Cited by 126 publications

(106 citation statements)

References 15 publications

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“…36,37 Two recent studies suggest that prolonged treatment might be required in some severe patients. 38,39 An almost complete recovery of white matter tracts pathology with associated significant improvement in memory, attention and executive functioning has been demonstrated in a recent study only following one year of a compliant treatment in severe OSA patients. 38 The need for longer treatment with CPAP in elderly has also been suggested by findings of another small pilot study which has shown that treatment of severe OSA in Alzheimer's patients (of mild to moderate severity) is associated with significantly slower cognitive decline over three years.…”

Section: Introductionmentioning

confidence: 99%

“…38 The need for longer treatment with CPAP in elderly has also been suggested by findings of another small pilot study which has shown that treatment of severe OSA in Alzheimer's patients (of mild to moderate severity) is associated with significantly slower cognitive decline over three years. 39 Although less striking, limited evidence with drugs such as donepezil, physiostigmine, and fluticasone also points to better cognitive outcomes in treated patients 40,41 . So far, subjective cognitive complaints have been largely ignored in randomised controlled trials of treatments for OSA patients.…”

Section: Introductionmentioning

confidence: 99%

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Sleep apnoea and the brain: a complex relationship

Rosenzweig¹,

Glasser²,

Polšek³

et al. 2015

The Lancet Respiratory Medicine

209

211

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Summary (151/150 words)The complex relationship between obstructive sleep apnoea (OSA) and the brain is explored in this review. During the untreated apnoea/hypopnoea, intermittent hypoxia, reoxygenation and hyper/hypocapnia occur, in both adults and children, along with changes in cerebral blood flow and sleep fragmentation. They may in time result in cognitive deficits with functional consequences for work and school efficiency.The ability to assess how OSA affects cognition depends on the specificity and sensitivity of the tests, which are rarely developed specifically for OSA. In this review we discuss both the neural adaptive and maladaptive processes to hypoxemia. Their net result on cognitive and emotional performance depends on the stage of this dynamic process, effects on other body systems, cognitive reserve and the idiosyncratic susceptibility. The contribution of fragmented sleep and the disruption of sleep structure is also explored, with a focus on its effects at different times in the genesis of the disease. Lancet Respiratory Medicine

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sleep apnoea and the brain: a complex relationship

Rosenzweig¹,

Glasser²,

Polšek³

et al. 2015

The Lancet Respiratory Medicine

209

211

View full text Add to dashboard Cite

show abstract

“…Seven studies included patients with either Alzheimer's disease [33,36,39,40,41,58] or Parkinson's disease [58] and three of these examined the effect of PAP on cognition [33,41,58]. The results suggested that PAP treatment in patients with Alzheimer's or Parkinson's disease results in good adherence (see Adherence section later), reduced apnoea-related symptoms (daytime sleepiness) and AHI, and led to deeper sleep [33,38,43,46].…”

Section: Dementiamentioning

confidence: 99%

Principles of practice parameters for the treatment of sleep disordered breathing in the elderly and frail elderly: the consensus of the International Geriatric Sleep Medicine Task Force

et al. 2016

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Sleep disordered breathing (SDB) is a leading cause of morbidity worldwide. Its prevalence increases with age. Due to the demographic changes in industrial societies, pulmonologists and sleep physicians are confronted with a rapidly growing number of elderly SDB patients. For many physicians, it remains unclear how current guidelines for SDB management apply to elderly and frail elderly patients. The goal of this consensus statement is to provide guidance based on published evidence for SDB treatment in this specific patient group.Clinicians and researchers with expertise in geriatric sleep medicine representing several countries were invited to participate in a task force. A literature search of PubMed from the past 12 years and a systematic review of evidence of studies deemed relevant was performed.Recommendations for treatment management of elderly and frail elderly SDB patients based on published evidence were formulated via discussion and consensus.In the last 12 years, there have been surprisingly few studies examining treatment of SDB in older adults and even fewer in frail older adults. Studies that have been conducted on the management of SDB in the older patient population were rarely stratified for age. Studies in SDB treatment that did include age stratification mainly focused on middle-aged and younger patient groups. Based on the evidence that is available, this consensus statement highlights the treatment forms that can be recommended for elderly SDB patients and encourages treatment of SDB in this large patient group. @ERSpublications An overview of the research in the field of and clinical guidelines for the treatment of SDB in elderly patients

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“…It has been suggested that treatment of OSA, particularly in the early stages of AD, when patients are still largely independent, may decelerate the progression of dementia (36,37). CPAP appears to be partially effective in improving episodic verbal learning, memory, cognitive flexibility and mental processing speed in patients with co-morbid AD and OSA (36).…”

Section: Review Articlementioning

confidence: 99%

Emerging co-morbidities of obstructive sleep apnea: cognition, kidney disease, and cancer

Gildeh¹,

Drakatos²,

Higgins³

et al. 2016

J. Thorac. Dis.

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Obstructive sleep apnea (OSA) causes daytime fatigue and sleepiness, and has an established relationship with cardiovascular and metabolic disease. Recent years have seen the emergence of an evidence base linking OSA with an increased risk of degenerative neurological disease and associated cognitive impairment, an accelerated rate of decline in kidney function with an increased risk of clinically significant chronic kidney disease (CKD), and with a significantly higher rate of cancer incidence and death. This review evaluates the evidence base linking OSA with these seemingly unrelated co-morbidities, and explores potential mechanistic links underpinning their development in patients with OSA, including intermittent hypoxia (IH), sleep fragmentation, sympathetic excitation, and immune dysregulation.

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Treatment of sleep apnoea syndrome decreases cognitive decline in patients with Alzheimer's disease

Cited by 126 publications

References 15 publications

Sleep apnoea and the brain: a complex relationship

Sleep apnoea and the brain: a complex relationship

Principles of practice parameters for the treatment of sleep disordered breathing in the elderly and frail elderly: the consensus of the International Geriatric Sleep Medicine Task Force

Emerging co-morbidities of obstructive sleep apnea: cognition, kidney disease, and cancer

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