Positive Airway Pressure Therapy for Sleep Apnea Can Reduce Risk of Dementia in Older Adults

People who used positive airway pressure therapy were less likely than others to receive a new diagnosis of dementia or mild cognitive impairment over the next 3 years.

A new study by Michigan Medicine’s Sleep Disorders Centers has found that older adults who receive positive airway pressure therapy for obstructive sleep apnea may be less likely to develop Alzheimer disease and other kinds of dementia.1

Obstructive sleep apnea is a condition in which the upper airway repeatedly collapses throughout the night, preventing normal breathing during sleep. It is associated with a variety of neurological and cardiovascular conditions, and many older adults are at high risk, according to the study authors.1 Dementia is also prevalent in this population, with approximately 5.8 million Americans currently living with the condition.1

Positive airway pressure is considered the first step for moderate to severe obstructive sleep apnea. Continuous positive airway pressure (CPAP) is the most commonly used method, although bilevel airway pressure, auto-titrating positive airway pressure, average volume assured pressure support, and adaptive support ventilation are also important in managing sleep-related breathing disorders.2

The investigators analyzed the Medicare claims of more than 50,000 Medicare beneficiaries aged 65 years and older who had been diagnosed with obstructive sleep apnea. The team examined whether those people who used CPAP therapy were less likely to receive a new diagnosis of dementia or mild cognitive impairment over the next 3 years, compared to people who did not receive the treatment.1

“We found a significant association between positive airway pressure use and lower risk of Alzheimer’s and other types of dementia over 3 years, suggesting that positive airway pressure may be protective against dementia risk in people with [obstructive sleep apnea],” said lead author Galit Levi Dunietz, PhD, MPH, an assistant professor of neurology and sleep epidemiologist, in the press release.1

According to the study authors, these findings emphasize the impact of sleep on cognitive function.

“If a causal pathway exists between [obstructive sleep apnea] treatment and dementia risk, as our findings suggest, diagnosis and effective treatment of OSA could play a key role in the cognitive health of older adults,” said principal investigator Tiffany J. Braley, MD, MS, an associate professor of neurology, in the press release.1


1. Treating Sleep Apnea May Reduce Dementia Risk [news release]. Michigan Medicine Health Lab; April 8, 2021. https://labblog.uofmhealth.org/lab-notes/treating-sleep-apnea-may-reduce-dementia-risk. Accessed April 16, 2021.

2. Weiss P, and Kryger M. Positive Airway Pressure Therapy for Obstructive Sleep Apnea. Otolaryngol Clin North Am; December 2016. https://pubmed.ncbi.nlm.nih.gov/27720457/. Accessed April 16, 2021.