Patients with sleep apnea see cognitive boost after 3 months of continuous posit

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Patients with sleep apnea see cognitive boost after 3 months of

continuous positive airway pressure

http://www.news-medical.net/?id=21264

Patients with obstructive sleep apnea (OSA) may improve their memory

by using continuous positive airway pressure (CPAP).

A new study published in the December issue of CHEST, the peer-

reviewed journal of the American College of Chest Physicians (ACCP),

shows that the majority of patients with OSA, who were memory-

impaired prior to treatment, demonstrated normal memory performance

after 3 months of optimal CPAP use. The study also showed that

memory improvement varied based on CPAP adherence. Patients who used

CPAP for at least 6 hours a night were nearly eight times as likely

to demonstrate normal memory abilities compared with patients who

used CPAP for 2 or fewer hours a night.

" Patients with OSA often complain of daily forgetfulness, eg,

losing their keys, forgetting phone numbers, or forgetting to

complete daily tasks, " said senior study author Mark S. Aloia, PhD,

National Jewish Medical and Research Center in Denver, CO, who

conducted his research while at Brown University Medical School,

Providence, RI. " Where memory is concerned, we may have the ability

to reverse some of the impairments by providing effective and

consistent use of CPAP treatment. "

Dr. Aloia and colleagues examined the degree to which varying levels

of CPAP adherence improved memory in 58 memory-impaired patients

with clinically diagnosed OSA. All patients underwent cognitive

evaluation involving verbal memory testing prior to initiation of

CPAP and at a 3-month follow-up visit. Patients were prescribed CPAP

machines, and adherence was covertly monitored using internal

microprocessors within each device. After treatment, patients were

divided into three groups based on their 3-month CPAP adherence: (1)

poor users (n=14), patients who averaged fewer than 2 hours/night of

CPAP use; (2) moderate users (n=25), patients who averaged 2 to 6

hours/night of CPAP use; and (3) optimal users (n=19), patients who

averaged more than 6 hours/night of CPAP use.

At baseline, all patients were found equally impaired in verbal

memory, with the average verbal memory score being approximately 2

SD below the mean for all participants. Following 3 months of CPAP

treatment, 21 percent of poor users, 44 percent of moderate users,

and 68 percent of optimal users demonstrated normal memory

performance. Compared with poor users, optimal users of CPAP were

nearly eight times as likely to demonstrate normal memory abilities.

Overall, the average verbal memory score for all patients improved

approximately 1 SD.

" Moderate use of CPAP may help, but it might not allow patients to

reach their full potential recovery where memory is concerned,

especially if memory is impaired at baseline, " said Dr. Aloia. " For

patients with OSA, the more regularly and consistently they use

CPAP, the better off they will be. " Dr. Aloia believes that getting

patients to use CPAP at least 6 hours a night could be a challenge

for physicians.

" Our findings also suggest that this optimal level of CPAP adherence

is uncommon following 3 months of treatment, " said Dr. Aloia. " We

need to find ways of encouraging patients to use their treatment all

night, every night in order to optimize treatment response. "

" CPAP has proven to be an effective treatment for patients with

OSA, yet adherence to treatment remains poor, " said Mark J. Rosen,

MD, FCCP, President of the American College of Chest

Physicians. " Physicians should educate their patients with OSA about

the importance of using CPAP consistently and discuss ways to

overcome obstacles to adherence. "

CHEST is a peer-reviewed journal published by the ACCP. It is

available online each month at www.chestjournal.org. The ACCP

represents 16,500 members who provide clinical respiratory, sleep,

critical care, and cardiothoracic patient care in the United States

and throughout the world. The ACCP's mission is to promote the

prevention and treatment of diseases of the chest through

leadership, education, research, and communication.

www.chestnet.org