Cinsiyete Göre Farklı Yaş Gruplarında Uyku Parametrelerindeki Değişiklikler

Year 2021, Volume: 10 Issue: 2, 117 - 124, 31.08.2021

Esra Duğral

https://doi.org/10.53424/balikesirsbd.971900

Abstract

Amaç: 65 yaş üstü ile daha genç grup hastalar arasında cinsiyete bağlı uyku parametrelerinde meydana gelen değişiklikleri incelemek.
Metot: Çalışmaya horlama, uykuda nefes durması, gündüz aşırı uykululuk hali (GAUH) gibi şikayetlerle uyku kliniğine başvuran ve Polisomnografisi (PSG) çekilen toplamda 293 hasta alınmıştır. Bu hastalardan 71 kişi 65 yaş üstü ( Erkek: 43, Kadın: 28) grupta, 222 kişi (Erkek: 139, Kadın:83) 45-60 yaşları arasındaki grupta bulunmaktadır. Hastaların tıbbi geçmişleri retrospektif olarak hasta dosyalarından taranmıştır. PSG parametrelerinden Total Uyku Süresi, Uyku Etkinliği (%), REM uyku oranı (%), NREM uyku oranı (%), AHI (Apne Hipopne indeksi), REM AHI, NREM AHI, minumun oksijen satürasyonu (min O2 sat), ortalama oksijen saturasyonu (ort O2 sat), oksijen desatürasyon süresi(dk ) ve oksijen desatürasyon indeksi (ODI) kayıt altına alınmıştır.
Bulgular: Cinsiyetlerden bağımsız olarak yaş grupları arasında uyku parametre değişiklikleri incelendiğinde Uyku etkinliğinin (total uyku süresinin yatakta kalma süresine oranı) 65 yaş üstü grupta daha genç gruba göre anlamlı olacak şekilde azalmış olduğu görüldü (73.69±17.49 ve 79.44±14.65 p: 0.014). Erkek hastalarda PSG parametrelerinden total uyku süresi (244.38±97.44 ve 284.51±93.40 ) ve uyku etkinliği verileri (73.55±16.16 ve 82.19±14.13 p:0.002 ) incelendiğinde 65 yaş üstü grubun verilerinin genç gruba göre düşük olduğu görüldü. Kadın hastalarda minumun ve ortalama oksijen satürasyonu incelendiğinde 65 yaş üstü grubun daha düşük seviyelere sahip olduğu görüldü (minumun oksijen sat: 71.14±13.52 ve 77.97±11.01 p:0.021, ortalama oksijen satürasyonu: 89.78±4.52 ve 91.93±3.70 p:0.030). Desatürasyon (%) ninde yaşlı grupta daha düşük olduğu tespit edildi (30.52±33.71 ve 12.22±18.97 p:0.012)
Sonuç: Bu çalışmada ileri yaşta uyku parametrelerinde daha genç yaşlara oranla total uyku süresinde, uyku etkinliğinde, minumum oksijen saturasyonunda, ortalama oksijen satürasyonunda ve desatürasyon (%) da azalmalar tespit edilmiştir. Sonuçların desteklenmesi ve yeni sonuçlar için; geniş katılımlı ve daha genç hastaların alındığı başka çalışmalara ihtiyaç duyulmaktadır.

Keywords

PSG, Total uyku süresi, Desatürasyon, İleri yaş, Cinsiyet

Changes in Sleep Parameters in Different Age Groups between Genders

Abstract

Aim: To examine the changes in sleep parameters related to sex between the patients over 65 years old and younger group.
Method:A total of 293 patients who applied to the sleep clinic with complaints such as snoring, cessation of breathing during sleep, and excessive daytime sleepiness (GAUH) and whose Polysomnography (PSG) were taken were included in the study. Of these patients, 71 people were in the group over 65 (Male: 43, Female: 28) and 222 people (Male: 139, Female: 83) were in the group between the ages of 45-60. The medical histories of the patients were retrospectively scanned from the patient files. Among the PSG parameters, Total Sleep Time, Sleep Efficiency (%), REM sleep rate (%), NREM sleep rate (%), AHI (Apnea Hypopnea index), REM AHI, NREM AHI, minimum oxygen saturation (min O2 hours), mean oxygen saturation (mean O2 hours), oxygen desaturation time (min) and oxygen desaturation index (ODI) were recorded.
Results: When sleep parameter changes between age groups were examined, regardless of gender, it was observed that sleep efficiency (the ratio of total sleep time to length of stay in bed) was significantly decreased in the 65+ age group compared to the younger group (73.69±17.49 and 79.44±14.65 p: 0.014). When the total sleep duration (244.38±97.44 and 284.51±93.40) and sleep efficiency data (73.55±16.16 and 82.19±14.13 p:0.002 ) of PSG parameters in male patients were examined, it was seen that the data of the over 65 age group were lower than the young group. When the minimum and mean oxygen saturation in female patients was examined, it was observed that the group over 65 years had lower levels (minimum oxygen saturation: 71.14±13.52 and 77.97±11.01 p:0.021, mean oxygen saturation: 89.78±4.52 and 91.93±3.70 p:0.030). Desaturation (%) was found to be lower in the elderly group also.(30.52±33.71 and 12.22±18.97 p:0.012)
Conclusion: In this study, decreases in total sleep duration, sleep efficiency, minimum oxygen saturation, average oxygen saturation and desaturation (%) were detected in sleep parameters in advanced age compared to younger ages. Further studies with larger participation and younger patients are needed to support the results and for the new results.

Keywords

PSG (Polisomnography), Total sleep time, Desaturation, Advanced age, Gender

References

• 1. Census USBot., 2000. Population Project Program, Washington, DC.
• 1. Census USBot., 2000. Population Project Program, Washington, DC.
• 2. www.tuik.gov.tr/İstatistiklerle Yaşlılar-2020-37227
• 2. www.tuik.gov.tr/İstatistiklerle Yaşlılar-2020-37227
• 3. Neubauer D. Sleep problems in the elderly. Am Fam Physician. 1999;59:2551-2558
• 3. Neubauer D. Sleep problems in the elderly. Am Fam Physician. 1999;59:2551-2558
• 4. Juergens TM, Barczi SR. Sleep. In: Duthie EH, Katz PR, Malone ML, eds. Practice of Geriatrics. 4th ed. Philadelphia, PA: Elsevier Saunders; 2007
• 4. Juergens TM, Barczi SR. Sleep. In: Duthie EH, Katz PR, Malone ML, eds. Practice of Geriatrics. 4th ed. Philadelphia, PA: Elsevier Saunders; 2007
• 5. Ancoli-Israel S, Shochat T. Insomnia in older adults. In: Kryger MH, Roth T, Dement WC, eds.Principles and Practice of Sleep Medicine. 5th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 135
• 5. Ancoli-Israel S, Shochat T. Insomnia in older adults. In: Kryger MH, Roth T, Dement WC, eds.Principles and Practice of Sleep Medicine. 5th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 135
• 6. Ohayon MM. Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev 2002; 6: 97-111 7. Falkmarken ND, “Uyku Fizyolojisi”, Türk Toraks Derneği Kitapları,” Uykuda Solunum Bozuklukları” 2015, “Uyku Fizyolojisi”, Türk Toraks Derneği Kitapları,” Uykuda Solunum Bozuklukları” 2015
• 6. Ohayon MM. Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev 2002; 6: 97-111 7. Falkmarken ND, “Uyku Fizyolojisi”, Türk Toraks Derneği Kitapları,” Uykuda Solunum Bozuklukları” 2015, “Uyku Fizyolojisi”, Türk Toraks Derneği Kitapları,” Uykuda Solunum Bozuklukları” 2015
• 8. Odens ML, Fox CH. Adult sleep apnea syndromes. Am Fam Physician. 1995;52:859–66
• 8. Odens ML, Fox CH. Adult sleep apnea syndromes. Am Fam Physician. 1995;52:859–66
• 9. Iber C, Ancoli-Israel S, Chesson AL and Quan SF fort he American Academy of Sleep Medicine. The AASM manual 2007 for the scoring of sleep and associated event: rules, terminology and technical specification, 1 ed: Westchester, Illinois : American Academy of Sleep Medicine, 2007
• 9. Iber C, Ancoli-Israel S, Chesson AL and Quan SF fort he American Academy of Sleep Medicine. The AASM manual 2007 for the scoring of sleep and associated event: rules, terminology and technical specification, 1 ed: Westchester, Illinois : American Academy of Sleep Medicine, 2007
• 10. Blake H, Gerard RW. Brain Potentials During Sleep. Am J Physiol 1937; 119:692–703.
• 10. Blake H, Gerard RW. Brain Potentials During Sleep. Am J Physiol 1937; 119:692–703.
• 11. Dement WC. History of Sleep Medicine. Neurologic Clinics 2005; 23: 945-965
• 11. Dement WC. History of Sleep Medicine. Neurologic Clinics 2005; 23: 945-965
• 12. Başoğlu ÖK, “Uyku ile ilgili genel tanımlar ve uyku bozuklukları sınıflaması, Türk Toraks Derneği Kitapları,” Uykuda Solunum Bozuklukları” 2015:38-56
• 12. Başoğlu ÖK, “Uyku ile ilgili genel tanımlar ve uyku bozuklukları sınıflaması, Türk Toraks Derneği Kitapları,” Uykuda Solunum Bozuklukları” 2015:38-56
• 13. Patil SP, What every clinician shouldknow about polysomnography. Respir Care 2010; 55:1179-95
• 13. Patil SP, What every clinician shouldknow about polysomnography. Respir Care 2010; 55:1179-95
• 14. Ancoli-Israel S, Roth T. Characteristics of insomnia in the United States: results of the 1991 National Sleep Foundation Survey. I. Sleep. 1999; 22 (Suppl 2): S347-53.
• 14. Ancoli-Israel S, Roth T. Characteristics of insomnia in the United States: results of the 1991 National Sleep Foundation Survey. I. Sleep. 1999; 22 (Suppl 2): S347-53.
• 15. Maggi S, Langlois JA, Minicuci N, Grigoltto F, et al. Sleep complaints in community-dwelling older persons: prevalence, associated factors, and reported causes. J Am Geriatr Soc 1998; 46(2): 161-8.
• 15. Maggi S, Langlois JA, Minicuci N, Grigoltto F, et al. Sleep complaints in community-dwelling older persons: prevalence, associated factors, and reported causes. J Am Geriatr Soc 1998; 46(2): 161-8.
• 16. Vitiello MV. Sleep disorders and aging: understanding the causes. J Gerontol 1997; 52A(4): M189-91.
• 16. Vitiello MV. Sleep disorders and aging: understanding the causes. J Gerontol 1997; 52A(4): M189-91.
• 17. Sukegawa T, Itoga M, Seno H, Miura S, Inagaki T, Saito W, et al. Sleep disturbances and depression in the elderly in Japan. Psychiatry Clin Neurosci 2003; 57(3): 265-70.)
• 17. Sukegawa T, Itoga M, Seno H, Miura S, Inagaki T, Saito W, et al. Sleep disturbances and depression in the elderly in Japan. Psychiatry Clin Neurosci 2003; 57(3): 265-70.)
• 18. Gulia KK, Kumar VM. Sleep disorders in the elderly: a growing challenge. Psychogeriatrics 2018;18:155–65
• 18. Gulia KK, Kumar VM. Sleep disorders in the elderly: a growing challenge. Psychogeriatrics 2018;18:155–65
• 19. Stanley N. The physiology of sleep and the impact of ageing. Europen Urology Supplements 2005; 6: 17-23.
• 19. Stanley N. The physiology of sleep and the impact of ageing. Europen Urology Supplements 2005; 6: 17-23.
• 20. Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep 2004;27:1255.
• 20. Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep 2004;27:1255.
• 21. World Health Organization. (1996), Research on the menopause in the 1990s. WHO Technical Report Series, 866,1-79.
• 21. World Health Organization. (1996), Research on the menopause in the 1990s. WHO Technical Report Series, 866,1-79.
• 22. Amore M, Donato PD, Berti A, Palareti A, Chirico C, Papalini A, Zucchini S. Sexual And Psychological Symptoms In The Climacteric Years. Maturitas 2006; 56: 303-11)
• 22. Amore M, Donato PD, Berti A, Palareti A, Chirico C, Papalini A, Zucchini S. Sexual And Psychological Symptoms In The Climacteric Years. Maturitas 2006; 56: 303-11)
• 23. Türkiye Nüfus ve Sağlık Araştırması. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, Ankara, 2008. ss:117
• 23. Türkiye Nüfus ve Sağlık Araştırması. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, Ankara, 2008. ss:117
• 24. Young, T., Shahar, E., Nieto, F. J., Redline, S., Newman, A. B., Gottlieb, D. J., et al. (2002). Predictors of sleep-disordered breathing in community-dwelling adults: the sleep heart health study. Archives of Internal Medicine, 162, 893–900.
• 24. Young, T., Shahar, E., Nieto, F. J., Redline, S., Newman, A. B., Gottlieb, D. J., et al. (2002). Predictors of sleep-disordered breathing in community-dwelling adults: the sleep heart health study. Archives of Internal Medicine, 162, 893–900.
• 25. Shamsuzzaman, A. S., Gersh, B. J., & Somers, V. K. (2003).Obstructive sleep apnea: implications for cardiac and vascular disease. JAMA., 290, 1906–1914.
• 25. Shamsuzzaman, A. S., Gersh, B. J., & Somers, V. K. (2003).Obstructive sleep apnea: implications for cardiac and vascular disease. JAMA., 290, 1906–1914.
• 26. Cofta S, Wysocka E, Piorunek T, Rzymkowska M, Batura-Gabryel H, Torlinski L., Oxidative stress markers in the blood of persons with different stages of obstructive sleep apnea syndrome, J Physiol Pharmacol. 2008 Dec;59 Suppl 6:183-90
• 26. Cofta S, Wysocka E, Piorunek T, Rzymkowska M, Batura-Gabryel H, Torlinski L., Oxidative stress markers in the blood of persons with different stages of obstructive sleep apnea syndrome, J Physiol Pharmacol. 2008 Dec;59 Suppl 6:183-90
• 27. Peppard, P. E., Young, T., Palta, M., & Skatrud, J. (2000). Prospective study of the association between sleep-disordered breathing and hypertension. The New England Journal of Medicine, 342, 1378– 1384.
• 27. Peppard, P. E., Young, T., Palta, M., & Skatrud, J. (2000). Prospective study of the association between sleep-disordered breathing and hypertension. The New England Journal of Medicine, 342, 1378– 1384.
• 28. Robinson, G. V., Stradling, J. R., & Davies, R. J. (2004). Sleep. 6: obstructive sleep apnoea/hypopnoea syndrome and hypertension. Thorax, 59, 1089–1094.
• 28. Robinson, G. V., Stradling, J. R., & Davies, R. J. (2004). Sleep. 6: obstructive sleep apnoea/hypopnoea syndrome and hypertension. Thorax, 59, 1089–1094.