Sleep Apnea After 65: Is Treatment Still Worth It?

For many people, yes. Randomized trials tested CPAP in adults 65 and older, including people over 70. CPAP reduced daytime sleepiness and improved some parts of sleep-related quality of life¹². Age by itself is not a reason to skip treatment.

What is sleep apnea, and why does it matter later in life?

Obstructive sleep apnea (OSA) is a condition in which the throat narrows or closes again and again during sleep. This briefly stops or reduces breathing. Doctors measure it with the apnea-hypopnea index (AHI), the number of these events per hour of sleep. An AHI of 15 to 29.9 is called moderate².

The most common treatment is CPAP (continuous positive airway pressure). This bedside machine sends gentle air pressure through a mask to keep the airway open. The benefits of CPAP were first proven mostly in middle-aged adults¹. Until recently, it was less clear whether older adults gained as much¹².

Does CPAP help people over 65?

The PREDICT trial enrolled 278 people aged 65 or older with newly diagnosed sleep apnea. They came from 14 sleep centers in the United Kingdom¹. For 12 months, half received CPAP plus supportive care, and half received supportive care alone.

• Less sleepiness — CPAP reduced sleepiness scores at 3 months and kept that benefit at 12 months¹.
• Who gained most — People who used CPAP more, or who were sleepier at the start, improved the most¹.
• Cost — CPAP was marginally cost effective compared with supportive care alone¹.
• Safety — No serious harm was linked to CPAP use¹.

Some early gains did not last to 12 months, such as better mobility and lower cholesterol at 3 months. Mood, daily function, nighttime urination, accidents, thinking skills and heart events did not change¹. Based on the results, the researchers recommended offering CPAP routinely to older patients with sleep apnea¹.

What about people over 70?

A trial in Spain studied 145 adults aged 70 and older who had moderate sleep apnea. Their average age was about 75². Half used CPAP for three months, and half did not.

The CPAP group had a larger drop in daytime sleepiness. They also improved in some sleep-related symptoms. And they improved in parts of a sleep quality-of-life survey, including nighttime symptoms and emotions².

However, CPAP did not change scores on thinking tests, anxiety or depression, or blood pressure in this trial². People who gained the most in sleepiness also tended to gain the most in quality of life².

Can CPAP help mood, memory or lifespan in older adults?

A 2025 review combined 13 studies of people over 65 with moderate to severe sleep apnea. In total there were nearly 15,000 participants³. Compared with usual care, CPAP was linked to³:

• Less sleepiness — Less daytime sleepiness and fewer daytime symptoms
• Better mood — Small improvements in anxiety and depression
• Thinking tests — Small improvements on two tests of attention and thinking speed
• Lifespan — Lower death rates

These results are encouraging, but they are mixed. The trials above did not show changes in mood or thinking tests¹². Results for blood pressure, memory and thinking tests were not consistent across trials¹². The review included different kinds of studies, and its authors called for larger, well-designed trials³. For now, the clearest benefit of CPAP in older adults is feeling less sleepy during the day.

What if CPAP is hard to use?

Getting used to CPAP takes time at any age. A mask that fits well, the right pressure settings and follow-up visits can make a big difference. Family members can help with setup, cleaning and reminders.

Regular use matters. The benefit was larger in people who used CPAP more¹³. Benefits were clearest in people who used CPAP more than four hours a night³. So it is worth working through problems instead of giving up.

At Universal Sleep Solutions, we offer in-lab and home sleep testing, plus CPAP and BiPAP setup and follow-up. When CPAP is not a good fit, we offer other options, including Inspire evaluation and oral appliance referral. We also offer CBT-I, a structured program for insomnia, for people who have trouble sleeping.

When should you get evaluated?

Talk with your doctor about a sleep evaluation if you or a loved one over 65:

• Snoring or gasping — Snores loudly, or has pauses in breathing or gasping during sleep
• Daytime sleepiness — Feels sleepy or dozes off during the day, such as while reading or watching TV
• Stopped treatment — Has been diagnosed with sleep apnea in the past but stopped treatment
• Poor sleep — Wakes often during the night or wakes up unrefreshed

A sleep study can show whether sleep apnea is present and how severe it is. Contact Universal Sleep Solutions to schedule an evaluation.