Comparing Mandibular Advancement Device and CPAP Therapy for Improving Cognitive Function in Adults with Sleep Apnea and Cardiovascular Risk

What this Trial Is About

Obstructive sleep apnea OSA is a common condition that causes breathing problems during sleep due to a blocked airway. It affects many adults worldwide and can lead to poor sleep, low oxygen levels, and increased health risks. People with OSA are more likely to develop cognitive problems, and the condition also results in a large economic burden. This trial aims to compare two treatments, continuous positive airway pressure CPAP and mandibular advancement devices MAD, to see how they affect cognitive function and other health outcomes in adults with OSA and cardiovascular risks, focusing on Asian populations. Participants diagnosed with moderate-to-severe OSA and mild cognitive impairment will be randomly assigned to receive either CPAP or MAD treatment in equal groups. CPAP uses a machine to keep the airway open by providing constant air pressure during sleep, while MAD is a custom oral device that moves the lower jaw forward to prevent airway blockage. The study will include baseline assessments and follow-ups at six and twelve months, measuring cognitive function with the Montreal Cognitive Assessment MoCA and monitoring treatment adherence. During the trial, participants will undergo tests including brain MRI scans to explore brain structure and function, ambulatory blood pressure monitoring, sleep quality questionnaires, and assessments of sleep apnea severity. Researchers will track changes in cognitive function, device adherence, sleepiness levels, and biomarkers over time. The study will help understand how each treatment impacts cognitive recovery and other health measures over one year, with ongoing safety and outcome monitoring throughout the study period.

CPAP vs MAD for OSA in Patients With Cognitive Impairment. A Randomized Clinical Trial