One Year of Continuous Positive Airway Pressure Adherence Improves Cognition in Older Adults With Mild Apnea and Mild Cognitive Impairment.

Only 17 participants were analyzed, and the study was not powered to detect small effects or correct for multiple comparisons. It was an exploratory secondary analysis of a subsample from a pilot trial, not a randomized controlled trial. Groups were formed by CPAP use, not random assignment, so adherent and non-adherent people may have differed in ways not measured. The adherent group received a multi-component adherence support intervention, so the study cannot show CPAP use alone caused any change. Baseline groups differed in antidepressant use and lowest oxygen saturation, and the analysis did not adjust for these. Three participants had missing Clinical Dementia Rating data, and two had missing self-rated change data. The study used different sleep diagnostic methods and did not standardize oxygen saturation variables.

The article is listed as NIH extramural research support, and the authors reported no conflicts of interest.

Do not conclude that CPAP alone improves cognition or prevents dementia. The study had only 17 participants, was not randomized, and the adherent group also received education, treatment expectations, barrier minimization, positive first CPAP experience, motivational interviewing, anticipatory guidance and follow-up for common CPAP problems, and study-partner support. Memory did not show a significant improvement, and the Clinical Dementia Rating and self-rated change trends were not significant.