There was a time when physicians questioned the need to treat advanced heart disease in the elderly. Aggressive therapy was shown to prolong life even in patients in their 80s. Similarly we now have patients in the mid to late 80s on hemodialysis for kidney failure. It is in this context that I found this article interesting from the Journal of Clinical Sleep Medicine (http://aasmnet.org/jcsm)
Why? : Obstructive sleep apnea (OSA) is prevalent in 30-80% of elderly (>65 year olds). Despite this it is under-treated. OSA has been linked to sleep fragmentation, and increased heart disease and stroke. Treatment has been shown to help lower the incidence of these problems. In young patients vigilance and learning capacity have been shown to improve with treatment of sleep apnea.
What? : Does treatment with CPAP improve memory performance in elderly patient?
Who? : A population of 126 French mostly elderly men (75 years on avg), with body mass index of 26-27 kg/m2 (this is considered overweight and not obese) in 2002-2003. 33 went on CPAP (by choice) and 93 without. They were followed up between 2009 and 2012.
Findings: On average patients used CPAP for >4hrs and for 85% of the nights. Patients with sleep apnea showed a more severe deterioration of executive functioning and episodic memory over time. CPAP enabled maintenance of certain cognitive functions, i.e. delayed free recall, attention and executive functioning. CPAP therapy compliance was excellent in this population, with only 2 patients stopping treatment.
Sleep medicine is an exciting field. I believe that this is because many other fields of medicine feed into it. These include Neurology, Pulmonary medicine, Psychiatry and Pediatrics (sort of like your neighborhood bar on a weekend night). This is not unexpected since we spend 7-9hrs a day asleep. This time reflects one-third of our lives. The proportion of our day we spend asleep is even longer in children.
This blog is my attempt at summarizing interesting and new sleep related journal / news articles. The list of articles I summarize here is not a reflection of either their importance or the importance of the journal they are quoted from. They are only a reflection of what piqued my interest. This is NOT medical advice. There is a long process before something published in a research study becomes standard of care. So again, this is NOT medical advice.