CPAP curbs sleepiness in demented apnea patients

May 30 (Reuters Health) - Nasal CPAP therapy reduces daytime sleepiness in patients with Alzheimer's disease and sleep-disordered breathing, according to a new study.
People who experience sleep apnea, brief episodes when breathing stops during sleep, are often treated with CPAP or continuous positive airway pressure to help them breathe properly during the night. With CPAP, a mask worn over the nose and mouth during sleep delivers air to the patient's throat, which helps prevent the airway blockage that occurs with sleep apnea.
It's estimated that up to 70 percent of patients with Alzheimer's disease have sleep-disordered breathing. CPAP has been shown to reduce daytime sleepiness in non-demented adults with sleep-disordered breathing.
In their study, Dr. Mei S. Chong and colleagues from the University of California at San Diego tested the effects of CPAP in 39 elderly patients with mild-moderate probable Alzheimer's and sleep-disordered breathing. They randomly assigned these individuals to 6 weeks of real CPAP or to 3 weeks of sham CPAP followed by 3 weeks of real CPAP.
With real CPAP, daytime sleepiness was markedly reduced relative to baseline. The level of improvement was comparable to that seen in a diverse population of middle-aged adults with sleep-disordered breathing.
Improvement in daytime sleepiness was seen after 3 weeks of CPAP and no additional improvement was evident after 6 weeks.
In the sham CPAP group, there was no significant improvement in daytime sleepiness after 3 weeks of sham CPAP but a significant improvement was detected after 3 weeks of real CPAP.
Chong and colleagues conclude that the decision to treat sleep-disordered breathing in patients with Alzheimer's "should be based on the same clinical standards that are applied to any age group and not based on cognitive status."
The results of this study, they add, suggest that elderly patients with mild-moderate dementia are able to tolerate CPAP, that CPAP reduces the number of sleep-disordered breathing episodes, and that daytime sleepiness is significantly reduced.
SOURCE: Journal of the American Geriatrics Society, May 2006.