University Lille North of France, CHU, Lille, France EA 1046, Lille, France Memory Clinic, Lille, France.
University Lille North of France, CHU, Lille, France EA 1046, Lille, France Department of Neurophysiology and Sleep Unit, Lille, France.
J Neurol Neurosurg Psychiatry. 2014 Dec;85(12):1405-8. doi: 10.1136/jnnp-2013-307544. Epub 2014 May 14.
It is essential to detect and then treat factors that aggravate Alzheimer's disease (AD). Here, we sought to determine whether or not continuous positive airway pressure (CPAP) therapy for sleep apnoea syndrome (SAS) slows the rate of cognitive decline in mild-to-moderate AD patients.
Between January 2003 and June 2011, we included consecutive, mild-to-moderate AD patients (a Mini Mental State Examination (MMSE) score at inclusion ≥15) with severe SAS as determined by video-polysomnography (an apnoea-hypopnoea index ≥30). In this single-blind, proof-of-concept trial, we analysed the mean decline in the annual MMSE score (the main outcome measure) according to whether or not the patients had received CPAP therapy. The decline was computed for each patient and for the first 3 years of follow-up.
Of the 23 included patients, 14 underwent CPAP treatment. The CPAP and non-CPAP groups did not differ significantly in terms of their demographic characteristics or MMSE score at baseline. The median annual MMSE decline was significantly slower in the CPAP group (-0.7 (-1.7; +0.8)) than in the non-CPAP group (-2.2 (-3.3; -1.9); p=0.013).
In this pilot study, CPAP treatment of severe SAS in mild-to-moderate AD patients was associated with significantly slower cognitive decline over a three-year follow-up period. Our results emphasise the importance of detecting and treating SAS in this population.
发现并治疗加重阿尔茨海默病（AD）的因素至关重要。在这里，我们旨在确定睡眠呼吸暂停综合征（SAS）的持续气道正压通气（CPAP）治疗是否会减缓轻度至中度 AD 患者的认知能力下降速度。
在 2003 年 1 月至 2011 年 6 月期间，我们纳入了连续的轻度至中度 AD 患者（入组时的简易精神状态检查（MMSE）评分≥15），并通过视频多导睡眠图（呼吸暂停-低通气指数≥30）确定其患有严重 SAS。在这项单盲、概念验证试验中，我们根据患者是否接受 CPAP 治疗分析了每年 MMSE 评分的平均下降情况（主要观察指标）。为每位患者和前 3 年的随访计算下降情况。
在 23 名纳入的患者中，有 14 名接受 CPAP 治疗。CPAP 组和非 CPAP 组在人口统计学特征或基线 MMSE 评分方面无显著差异。CPAP 组的中位年 MMSE 下降明显较慢（-0.7[-1.7;+0.8]），而非 CPAP 组的下降速度较快（-2.2[-3.3;-1.9];p=0.013）。
在这项初步研究中，在轻度至中度 AD 患者中，严重 SAS 的 CPAP 治疗与三年内认知能力下降速度显著减缓相关。我们的研究结果强调了在该人群中发现和治疗 SAS 的重要性。
