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Adherence to Continuous Positive Airway Pressure Treatment in Patients With Alzheimer's Disease and Obstructive Sleep Apnea

From the Department of Psychiatry (LA, SA-I, MM, BWP, LL, DG), University of California, San Diego, San Diego, CA, Veterans Affairs San Diego Health Care System (LA, SA-I, CS, LL, JSL, JC-B, DG, JC), the Department of Medicine (JSL, JC), University of California, San Diego, San Diego, CA, and the Department of Neurosciences (JC-B), University of California, San Diego, San Diego, CA.

Objective: This analysis examined whether patients with Alzheimer disease (AD) tolerate continuous positive airway pressure (CPAP).

Method: Thirty patients with AD were randomized to CPAP or sham CPAP and completed sleep, depression, and quality-of-life questionnaires. Participants could choose to continue treatment after the trial.

Results: Patients wore CPAP for 4.8 hours per night. More depressive symptoms were associated with worse adherence (r_S= –0.37; N = 30, p <0.04). Patients who continued using CPAP had fewer depressive symptoms (t [19] = 2.45, p = 0.02) and better adherence (t [19] = 2.32, p = 0.03) during the trial.

Conclusion: Patients with AD with obstructive sleep apnea can tolerate CPAP. Adherence and long-term use may be more difficult among those patients with more depressive symptoms.

Key Words: Sleep apnea • CPAP • Alzheimer disease • adherence

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