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

Yaşlı Obstrüktif Uyku Apneli Hastalarda Klinik ve Polisomnografik Farklılıklar

Abstract

Amaç: Toplumda uyku ile ilgili şikayetler yaygın olarak bulunsa da yaşlı obstrüktif uyku apneli (OSA) hastalardaki klinik ve polisomnografik farklılıklar hakkındaki bilgiler sınırlıdır. OSA tanısı konmuş hastalarda yaşın klinik ve polisomnografik bulgular üzerindeki etkisini araştırmak amaçlandı. Gereç ve Yöntem: Retrospektif olarak 2011-2014 yılları arasında gözetimli polisomnografi yapılarak OSA tanısı (AHİ≥ 5/sa) konulan 216 (100 K/116 E) hasta çalışmaya dahil edildi. Hastalar genç-orta yaşlı (<65 yıl) (Grup 1) ve yaşlı (≥65 yıl) (Grup 2) olmak üzere iki gruba ayrıldı. Hastaların semptomları, eşlik eden hastalıkları ve polisomnografik bulguları karşılaştırıldı. Bulgular: Grup 1’de 185 (82 K/103 E), Grup 2’de 31 (18 K/13E) hasta vardı. Her iki grupta cinsiyet dağılımı, OSAS ile ilişkili semptom sıklığı ve Epworth uykululuk skalası açısından fark yoktu (sırasıyla; p=0,156, p>0,05, p=0,761). Grup 2’de istatistiksel olarak hipertansiyon, atherosklerotik kalp hastalığı, diabetes mellitus, depresyon ve KOAH (sırasıyla p=0,05, p=0,005, p=0,002, p=0,007, p=0,035) daha sıktı. Polisomnografik bulgular açısından istatistiksel anlamlılığı olmamakla birlikte Grup 2’de TST daha kısa, uyku etkinliği daha düşük, N1 %’si daha yüksek (sırasıyla; p=0,129, p=0,127, p=0,209), Grup 1’de ise uyku başlangıcı daha geç, arousal indeksi daha yüksekti (p=0,468, p=0,545). Benzer şekilde istatistiksel anlamlılığı olmamakla birlikte AHİ yaşlı grupta daha yüksek, gece boyu ortalama total SpO2 ise daha düşüktü (sırasıyla; p=0,699, p=0,063). Ortalama apne süreleri açısından iki grup arasında fark yoktu (p=0,634). Sonuç: Yaşlı OSA sayısı az olmakla birlikte, yaştan bağımsız olarak OSA’lılar benzer semptom ve polisomnografik bulgulara sahiptir. Eşlik eden hastalıklar da dikkate alındığında yaşlı hastalarda OSA’nın göz ardı edilmemesi gerekmektedir.

Keywords

• Obstrüktif Uyku Apnesi
• OSA
• Yaşlılık

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