Study links untreated OSA to faster cognitive decline

GAINESVILLE, Fla. - Older adults with untreated obstructive sleep apnea (OSA) experienced faster cognitive decline over 10 years than those treated with CPAP, according to a study published in Alzheimer’s & Dementia. Researchers analyzed 777 participants from the 2011 National Health and Aging Trends Study who had at least one Medicare claim for OSA and no cognitive impairment at baseline. CPAP treatment was defined as having one or more CPAP claims. The researchers tracked cognitive performance from 2011 through 2021 using annual assessments and compared changes between participants who received CPAP treatment and those who did not. Cognitive performance declined in both groups over the follow-up period. Participants treated with CPAP declined by 0.03 standard deviation units per year, while untreated participants experienced a 69% faster rate of decline. The findings suggest that CPAP therapy may help slow cognitive decline in older adults with OSA. The researchers noted that earlier studies have found limited short-term cognitive benefits from CPAP treatment. However, cognitive decline develops gradually, and studies with shorter follow-up periods may not capture subtle changes that emerge over several years. The researchers noted that untreated OSA has previously been associated with a higher risk of dementia and cited several possible mechanisms, including inflammation, oxidative stress, intermittent hypoxia and sleep fragmentation. The study authors said the findings support the need for longer-term research on the relationship between OSA treatment and cognitive health. The study was led by Christopher N. Kaufmann and approved by the University of Florida Institutional Review Board, with reliance agreements at Johns Hopkins University and the University of Maryland, Baltimore.