The nine patients who refused CPAP treatment declined by three points on the Mini-Mental State Examination (MMSE) over five years, whereas the 28 patients who used CPAP regularly slipped by less than one point. Anne-Cécile Troussière, Université Lille Nord de France, presented her exploratory finding that mild to moderate AD patients with sleep apnea fare better if they use a continuous positive airway pressure (CPAP) device, which treats sleep apnea by applying a mild pressure to keep airways open. One poster presentation did look at sleep apnea treatment, though the study was retrospective rather than prospective.
#Nightowl sleep study trial
The findings matter, she said, “because sleep problems could be treatable, and intervention might delay or prevent some of the cognitive sequelae.” A next step would be to do a randomized controlled trial that tests whether improving the quality of sleep delays cognitive problems, Yaffe said. The mechanisms are not yet clear, but besides hypoxia they could have to do with Aβ accumulation, she added (see Part 2). But at least we are showing that sleep problems are predicting five-year outcomes related to nursing home placement and MCI and dementia,” Yaffe said at a press briefing. “The effect is probably bidirectional, meaning disordered sleep may cause dementia at the same time that dementia causes sleep trouble. In addition, a delay in falling asleep and less efficient sleep both increased the risk of being placed in a nursing home five years later. This latter finding may be explained by hypoxia rather than sleep fragmentation, said Yaffe (see ARF related news story on Yaffe et al., 2011). Separately, sleep-disordered breathing (or sleep apnea) at baseline also heightened the risk of developing MCI or dementia almost twofold. For one thing, a late shift in the women’s circadian rhythm, where their mean peak daily activity moved by two hours from early to late afternoon, was linked to an almost two-fold increased risk for developing MCI or dementia (see Tranah et al., 2011). Yaffe found that several sleep-related problems raised the risk of subsequent cognitive decline. Five years after those tests, the scientists checked to see who had since developed mild cognitive impairment (MCI) or dementia. They also underwent polysomnography, a lab-based sleep study that takes more in-depth measurements of overnight sleep patterns.
Fifteen years into the study, about 3,000 of those women underwent actigraphy, whereby a watch-like device worn on the wrist measures sleep by recording movement over several days.
#Nightowl sleep study free
Yaffe and colleagues followed a prospective, multicenter cohort of community-dwelling women, all of whom were 65 or older and free of dementia at enrollment. Kristine Yaffe, University of California, San Francisco, presented her recent epidemiological findings on sleep-some published and some not. “Sleep disruptions throughout the lifespan are probably accelerators of cognitive aging and risk factors for dementia,” he said. “It is unusual to have studies coming together at the same time to say the same thing,” said Constantine Lyketsos, Johns Hopkins Bayview Medical Center, Baltimore, Maryland. In particular, objective sleep measures suggesting that sleep disorders predict decline added a new layer of experimental data to older self-reported hints that how long and how well one sleeps might affect brain health later in life. At the Alzheimer’s Association International Conference held 14-19 July 2012 in Vancouver, Canada, both epidemiological and lab findings converged to point a finger at sleep in connection to cognitive decline.
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