{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:11:51Z","timestamp":1792789911198,"version":"4.5.0"},"reference-count":61,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"COCKPI-Takeda Funding Research","award":["RKE-21-0591"],"award-info":[{"award-number":["RKE-21-0591"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurology International"],"abstract":"<jats:p>Background: Obstructive sleep apnea (OSA) is highly prevalent in the early stages of Alzheimer\u2019s disease (AD), and its hallmark, sleep fragmentation, may accelerate cognitive decline. Continuous positive airway pressure (CPAP) improves OSA-related hypoxia during slow-wave sleep, but its cognitive benefits in AD remain unclear. Methods: We performed a 12-month sub-analysis of a prospective, longitudinal pilot study that enrolled 21 adults (median age = 77 yr; 71% women) with Mild Cognitive Impairment (MCI) with AD confirmed biomarkers and polysomnography-diagnosed OSA. All participants underwent baseline overnight polysomnography (PSG) and neuropsychological testing (Clinical Dementia Rating (CDR), Mini-Mental State Examination (MMSE), Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)) that were repeated after 12 months. Twelve participants were CPAP-compliant (moderate\/severe OSA) and nine were non-users (mild OSA\/intolerance). Cognitive change scores (\u0394 = 12 months -baseline) were compared with Generalized Linear Models (GLM) adjusted for baseline cognition and Apnea\u2013Hypopnea Index (AHI); associations between baseline sleep parameters and cognitive trajectories were examined. And the association of sleep variables with the use of CPAP was also evaluated. Results: Compared with non-users, CPAP users showed significantly slower global decline (\u0394 MMSE: p = 0.016) and improvements in overall cognition (\u0394 RBANS Total: p = 0.028) and RBANS sub-domains (\u0394 RBANS FC: p = 0.010; \u0394 RBANS SF: p = 0.045). Longer baseline non-rapid eye movement (NREM) stage 3 and rapid eye movement (REM) sleep, greater total sleep time and sleep efficiency, and right-side sleeping were each linked to better cognitive outcomes, whereas extended NREM stage 2, wakefulness, and supine sleeping were associated with poorer trajectories. Conclusions: Twelve months of CPAP use was associated with attenuated cognitive decline and domain-specific gains in AD-related MCI with OSA. Sleep architecture and body position during sleep predicted cognitive outcomes, underscoring the therapeutic relevance of optimizing breathing and sleep quality. Larger, longer-term trials are warranted to confirm CPAP\u2019s disease-modifying potential and to clarify the mechanistic role of sleep in AD progression.<\/jats:p>","DOI":"10.3390\/neurolint17090147","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T14:23:50Z","timestamp":1757600630000},"page":"147","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Pilot Study: The Effect of CPAP Intervention on Sleep Architecture and Cognition in Alzheimer\u2019s Disease Patients with Obstructive Sleep Apnea"],"prefix":"10.3390","volume":"17","author":[{"given":"Carmen L.","family":"Frias","sequence":"first","affiliation":[{"name":"Fundaci\u00f3 per a Doc\u00e8ncia I Recerca, M\u00fatuaTerrassa, 08221 Terrassa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Almeria","sequence":"additional","affiliation":[{"name":"Department of Neurology, Fundaci\u00f3 Assistencial M\u00fatua Terrassa, 08221 Terrassa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Castejon","sequence":"additional","affiliation":[{"name":"Department of Neurology, Fundaci\u00f3 Assistencial M\u00fatua Terrassa, 08221 Terrassa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Artero","sequence":"additional","affiliation":[{"name":"Department of Neurology, Fundaci\u00f3 Assistencial M\u00fatua Terrassa, 08221 Terrassa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Caruana","sequence":"additional","affiliation":[{"name":"Department of Neurology, Fundaci\u00f3 Assistencial M\u00fatua Terrassa, 08221 Terrassa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Elias-Mas","sequence":"additional","affiliation":[{"name":"Department of Neurology, Fundaci\u00f3 Assistencial M\u00fatua Terrassa, 08221 Terrassa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4846-8959","authenticated-orcid":false,"given":"Karol","family":"Uscamaita","sequence":"additional","affiliation":[{"name":"Neurology Department, Adsalutem Institute Sleep Medicine, 08008 Barcelona, Spain"},{"name":"Neurology Service, Sleep Disorders Unit, Hospital Universitari Sagrat Cor, Grupo Quir\u00f3nsalud, 08029 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9505-6776","authenticated-orcid":false,"given":"Virginia","family":"Hawkins","sequence":"additional","affiliation":[{"name":"Department of Psychology, Brooks Building, Faculty of Science and Education, Manchester Metropolitan University, Manchester M1 5GD, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola J.","family":"Ray","sequence":"additional","affiliation":[{"name":"Department of Psychology, Brooks Building, Faculty of Science and Education, Manchester Metropolitan University, Manchester M1 5GD, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariateresa","family":"Buongiorno","sequence":"additional","affiliation":[{"name":"Neurology Department, Vall d\u2019Hebron University Hospital, 08035 Barcelona, Spain"},{"name":"Neurovascular Diseases Research Group, Vall d\u2019Hebron Research Institute, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Cullell","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3 per a Doc\u00e8ncia I Recerca, M\u00fatuaTerrassa, 08221 Terrassa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerzy","family":"Krupinski","sequence":"additional","affiliation":[{"name":"Department of Neurology, Fundaci\u00f3 Assistencial M\u00fatua Terrassa, 08221 Terrassa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s13195-023-01181-1","article-title":"Neural biomarker diagnosis and prediction to mild cognitive impairment and Alzheimer\u2019s disease using EEG technology","volume":"15","author":"Jiao","year":"2023","journal-title":"Alzheimer\u2019s Res. 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