Clinical and Polysomnographic Differences in Elderly Obstructive Sleep Apnea Patients
Abstract
Objectives: Although sleep-related complaints are common in the community, knowledge about clinical and polysomnographic differences in elderly patients with obstructive sleep apnea (OSA) is limited. The aim of this study was to compare the clinical and polysomnographic characteristics of OSA patients who were older than 65 years and those younger than 65 years.
Materials and Methods: We retrospectively reviewed the polysomnography data of 216 (100 F/116 M) OSA patients who underwent polysomnography between 2011 and 2014. The patients were divided into two groups: <65 years (Group 1), ≥65 years (Group 2). We evaluated symptoms, comorbidities, and polysomnographic findings of the two groups of patients.
Results: There were 185 patients (82 F/103 M) in Group 1 and 31 patients (18 F/13 M) in Group 2. There were no differences in gender distribution, OSA-related symptom frequency and Epworth sleepiness scale rates between two groups. The comorbidities, including hypertension (p=0.05), atherosclerotic heart disease (p=0.005), diabetes mellitus (p=0.002), depression (p=0.007), and COPD (p=0.035), were more frequent in Group 2. Although statistically non-significant, TST, sleep efficiency and average oxygen saturation at sleep were lower (p=0.129, p=0.127, p=0.063, respectively) whereas the AHI and the arousal index were higher (p=0.699, p=0.545, respectively) in Group 2. There was no difference between the two groups in terms of mean apnea duration.
Conclusion: OSA patients had similar symptoms and polysomnographic findings independent from age. OSA should not be ignored in elderly patients when comorbidities are considered.
Keywords
Obstructive Sleep Apnea, OSA, Elderly
Ethical Statement
Ethical approval was obtained from Ankara University Clinical Research Ethics Committee (İ6- 374-20).
References
- 1. Roche F, Hupin D, Saint-Martin M, Sforza E. Elderly patients. Elderly patients. ERS Monogr. 2015;67:90-102.
- 2. Young T, Palta M, Dempsey J, Skatrud J, Weber, S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230-1235.
- 3. Ancoli-Israel S, Kripke DF, Klauber MR, Mason WJ, Fell R, Kaplan O. Sleep disordered breathing in community-dwelling elderly. Sleep. 1991;14:486- 95.
- 4. Bixler EO, Vgontzas AN, Ten Have T, Tyson K, Kales A. Effects of age on sleep apnea in men. I. Prevalence and severity. Am J RespirCrit Care Med. 1998;157:144-148.
- 5. Launois S. H, Pe´pin J-L, Le´vy P. Sleep apnea in the elderly: A specific entity? Sleep Medicine Reviews. 2007;11:87-97
- 6. Iber C, Ancoli-Israel S, Chesson AL Jr, Quan SF. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications, 1st edn. American Academy of Sleep Medicine, Westchester, IL, 2007.
- 7. Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med. 2002;165:1217- 1239.
- 8. Bixler EO, Vgontzas AN, Ten Have T, Tyson K, Kales A. Effects of age on sleep apnea in men: I. Prevalence and severity. Am J Respir Crit Care Med. 1998;157:144-148.
- 9. Young T, Shahar E, Nieto FJ, Redline S, Newman AB, Gottlieb DJ, et al. Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study. Arch Intern Med. 2002;162:893-900.
- 10. Burger CD, Stanson AW, Sheedy 2nd PF, Daniels BK, Shepard Jr JW. Fastcomputed tomography evaluation of age-related changes in upper airway structure and function in normal men. Am Rev Respir Dis. 1992;145:846- 852.