Treatment of obstructive sleep apnea using CPAP and cognitive impairment

Study objective : To evaluate the association between obstructive sleep apnea (OSA) and cognitive impairment by comparing individuals with continuous positive airway pressure (CPAP)-treated OSA, untreated OSA, and those without OSA. Methods In this cross-sectional study, participants were divided into 3 groups based on overnight sleep study and CPAP use: (1) OSA–CPAP group, (2) OSA–no treatment group, and (3) non–OSA group. The primary outcome was the prevalence of cognitive impairment among 3 groups measured by Montreal Cognitive Assessment (MoCA) and the secondary outcome was ambulatory blood pressure monitoring (ABPM). Results A total of 113 participants (male 69.9%, median age: 57.0 years) are enrolled, comprising 50 participants in the OSA–CPAP group, 50 participants in the OSA–no treatment group, and 13 participants in the non–OSA group. The cognitive impairment prevalence was 46.0% in the OSA–CPAP group, 70.0% in the OSA–no treatment group, and 46.0% in the non-OSA groups (p = 0.038). Subdomain analysis showed significantly higher scores in memory and visuospatial abilities in the OSA–CPAP and the non–OSA group (p = 0.039 and p = 0.005). Post-hoc analysis revealed significantly higher MoCA scores and lower prevalence of cognitive impairment in the OSA–CPAP group compared to OSA–no treatment group (p = 0.002 and p = 0.015). No significant differences in ABPM parameters were observed. Conclusions CPAP therapy in patients with OSA is associated with better cognitive performance and lower prevalence of cognitive impairment. These findings suggest a potential role for OSA treatment preserving cognitive function, however further longitudinal studies are needed.