A systematic review on adherence to continuous positive airway pressure (CPAP) treatment for obstructive sleep apnoea (OSA) in individuals with mild cognitive impairment and Alzheimer's disease dementia

Oliver, Cerys; Li, Haoxuan; Biswas, Bijetri; Woodstoke, David; Blackman, Jonathan; Butters, Anneka; Drew, Cheney; Gabb, Victoria; Harding, Sam; Hoyos, Camilla M; Kendrick, Adrian; Rudd, Sarah; Turner, Nicholas; Coulthard, Elizabeth

Abstract

Obstructive sleep apnoea (OSA) is highly prevalent in mild cognitive impairment (MCI) and Alzheimer's disease (AD). The gold standard treatment for OSA is continuous positive airway pressure (CPAP). Long-term, well-powered efficacy trials are required to understand whether CPAP could slow cognitive decline in individuals with MCI/AD, but its tolerability in this group remains uncertain. The present review investigates CPAP adherence among individuals with OSA and MCI/AD. Electronic searches were performed on 8 databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Six independent studies and four secondary analyses included 278 unique participants (mean age = 72.1 years). In five of the retained studies, around half of participants (45% N = 85 MCI, 56% N = 22 AD) were adherent to CPAP, where ≥4 h use per night was considered adherent. Three of the retained studies also reported average CPAP use to range between 3.2 and 6.3 h/night. CPAP adherence in individuals with MCI and AD is low, albeit similar to the general elderly population. Reporting adherence in future studies as both average duration as well as using a binary cut-off would improve our understanding of the optimum CPAP use in dementia clinical trials and care.

• Journal Article Type: Article
• Acceptance Date: Oct 16, 2023
• Online Publication Date: Oct 24, 2023
• Publication Date: Feb 28, 2024
• Deposit Date: Mar 12, 2024
• Publicly Available Date: Mar 12, 2024
• Journal: Sleep Medicine Reviews
• Print ISSN: 1087-0792
• Electronic ISSN: 1532-2955
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 73
• Article Number: 101869
• DOI: https://doi.org/10.1016/j.smrv.2023.101869
• Keywords: Alzheimer’s, Cognitive impairment, Sleep apnoea, Dementia, Continuous positive airway pressure
• Public URL: https://uwe-repository.worktribe.com/output/11462464