Geriatrik ve Erişkin Hastalarda Polisomnografik Özelliklerin Karşılaştırılması

Yıl 2024, Cilt: 21 Sayı: 1, 48 - 66, 30.01.2024

Aydın Balcı , Sule Cilekar , Ersin Günay , İbrahim Güven Çoşğun , Ahmet Dumanlı , Elif Dumanlı , Erkan Yıldız

Öz

Giriş: Çalışmamızda geriatrik ve erişkin hastalarda polisomnografi özelliklerinin karşılaştırılması amaçlandı.
Materyal ve Metod: Çalışmamız retrospektif vaka kontrol çalışması olarak yapıldı. Bozukluk ön tanısı ile polisomnografi laboratuvarına yatırılan Uyku Hastaları yaşlarına göre 65 yaş altı ve üstü olmak üzere 2 gruba ayrıldı. Uyku bozukluklarını saptamak için Alice 6 bilgisayarlı sistem (Respironics; Philips, Illinois, ABD) polisomnografi uygulandı.
Bulgular: Çalışmamıza 180 (%36) kadın, 320 (%64) erkek olmak üzere toplam 500 kişi dahil edildi. Yaş ortalaması 52.36 ± 13.69 idi. Geriatrik yaş grubunda Pozitif Hava Basıncı (PAP) tedavi oranları erişkinlere göre anlamlı olarak yüksekti. Erişkinlerde uyku etkinliği, ortalama uyku süresi ve toplam uyku süresi geriatrik hastalara göre daha yüksekti. Geriatrik hasta grubunda PSG sonucu en sık konulan tanı 84 (%) kişi ile Ağır OUAS tanısıydı. Uyku sırasındaki alt ekstremite mobilite ölçümleri değerlendirildiğinde ileri derecede OUAS'lı geriatrik hastalarda değerlerin anlamlı olarak daha yüksek olduğu bulundu. Evre 3 ve Rem evresi erişkinlerde NREM3 (%) ve REM (%) ölçümleri açısından anlamlı olarak daha yüksekti.
Sonuç: Geriatrik hastalarda uyku süreleri kısalmakta, uykuda huzursuz bacak hareketleri erişkin hastalara göre daha sık görülmektedir ve uykuda solunum bozukluğu genellikle geriatrik hastalarda daha şiddetlidir.

Anahtar Kelimeler

Geriatrik hastalar, Uyku apne sendromu, uyku tedavisi, apne hipopne indeksi

Comparison of Polysomnographic Characteristics in Geriatric and Adult Patients

Öz

Objectıve: In our study, it was aimed to compare polysomnography features in geriatric and adult patients.
Material and Methods: Our study was conducted as a retrospective case-control study. Sleep Patients who were hospitalized in the polysomnography laboratory with a pre-diagnosis of the disorder were divided into 2 groups according to their age as younger than 65 years old and over. Alice 6 computerized system (Respironics; Philips, Illinois, USA) polysomnography was applied to detect sleep disorders.
Results: A total of 500 people, including 180 (36%) women, 320 (64%) men, were included in our study. The mean age was 52.36 ± 13.69. Posittive Airvey Pressure (PAP) treatment rates were significantly higher in the geriatric age group compared to adults. Sleep efficiency, mean sleep time, and total sleep time were higher in adults compared to geriatric patients. In the geriatric patient group, the most common diagnosis as a result of PSG was the diagnosis of Severe OSAS with 84 (%) people. When the lower extremity mobility measurements during sleep were evaluated, the values were found to be significantly higher in geriatric patients with severe OSAS. Stage 3 and Rem stage were significantly higher in adults in terms of NREM3 (%) and REM (%) measurements.
Conclusion: Sleep times are reduced in geriatric patients, restless leg movements during sleep are more common than adult patients, and sleep-disordered breathing is generally more severe in geriatric patients.

Anahtar Kelimeler

Geriatric patients, Sleep apnea syndrome, sleep therapy, apnea hypopnea index

Kaynakça

• Ancoli-Israel, S., Gehrman, P., Kripke, D. F., Stepnowsky, C., Mason, W., Zion, M. C., et al. (2001). Long-term fallow-up of sleepdisordered breathing in older adults. Sleep Med, 2, 511-6.
• Ancoli-Israel, S., Kripke, D. F., Klauber, M. R., Mason, W. J., Fell, R., Kaplan, O. (1991). Sleep disordered breathing in community-dwelling elderly. Sleep, 14, 486–95.
• Avidan, A. Y. (2002). Sleep changes and disorders in the elderly patient. Curr Neurol Neurosci Rep, 2(2), 178–185.
• Bahar, Y., Annakkaya, A. N., Sen, C., Oktay, M., Aytekin, F., Balbay, O. (2019). Assessment of the frequency of deep venous thromboembolism in obstructive sleep apnea syndrome. Aging Male, 22, 1–6.
• Bixler, E. O., Vgontzas, A. N., Lin, H. M., Have, T. T., Rein, J., Bueno, A. V. et al.(2001). Prevalence of sleep-disordered breathing in women: Effects of gender. Am J Respir Crit Care Med, 163(3), 608–613.
• Calverley, P. M. A. (1998). Impact of sleep on respiration. European Respiratory Monograph, 10, 9-27.
• Dikis, O. Ş., Acat, M., Casim, H., Haskul, İ., Neselioglu, S., Simsek, A., et al. (2019). The relationship of thiol/disulfide homeostasis in the etiology of patients with obstructive sleep apnea: A case-control study. Aging Male, 3:1–8. Espiritu, J. R. (2008). Aging-related sleep changes. Clin Geriatr Med, 24, 1-14.
• Goder, R., Friege, L., Fritzer, G., Strenge, H., Aldenhoff, J. B., Selch, D. H., et al. (2003). Morning headhaches in patients with sleep disorders: a systematic polysomnographic study. Sleep Med, 4(5), 385–391. Hock, C. C., Reynolds, C.F.I., Monk, TH, Buysse, D. J., Yeager, A.L., Houck, P. R., et al. (1990). Comparison of sleep disorderedbreathing among healthy elderly in the seventh, eighth, andninth decades of life. Sleep, 13(6), 502-11. Hongyo, K., Ito, N., Yamamoto, K., Yasunobe, Y., Takeda, M., Oguro, R., et al. (2017). Factors associated with the severity of obstructive sleep apnea in older adults. Geriatr Gerontol Int, 17(4), 614–621.
• Janssens, J. P., Pautex, S., Hilleret, H., Michel, J. P. (2000). Sleep-disordered breathing in the elderly. Aging Clin Exp Res), 12(6), 417–429.
• Lavie, P., Lavie, L., Herer, P. (2005). All-cause mortality in males with sleep apnoea syndrome: Declining mortality rates with age. Eur Respir J, 25(3), 514–520.
• Lee, S. D., Kang, S. H., Ju, G., Han, J. W., Kim, T. H., Lee, C.S., et al. (2014). The prevalence of and risk factors for sleep-disordered breathing in an elderly Korean population. Respiration, 87(5), 372–378.
• Malhotra, A., Huang, Y., Fogel, R, Lazic, S., Pillar, G., Jakab, M., et al. (2006). Aging influences on pharyngeal anatomy and physiology: The predisposition to pharyngeal collapse. Am J Med, 119, 72. e9–e14.
• Martin, J., Shochat, T., Gehrman, P. R., Ancoli-Israel, S. (1999). Sleep in the elderly. In: Selecky PA (ed). Respiratory care clinics of North America. Sleep Disorders.WB Saunders. Philadelphia, Respir Care Clin N, 5(3), 461-72, ix.
• Martin, J., Stepnowsky, C. J., Ancoli-Israel, S. (2002). Sleep apnea in the elderly. In: McNicholas WT, Phillipson EA (eds). Breathing disorders in sleep. WB Saunders. Philadelphia, pp 278-87.
• National Institutes of Health State of the Science Conference Statement on Manifestations and Management of Chronic Insomnia in Adults, June 13–15. (2005). Sleep, 28, 1049–1057. Erişim adresi: doi.org/10.1093/sleep/28.9.1049. Erişim tarihi: 13 Ağustos 2023
• National Heart Lung and Blood Institute. How much sleep is enough? Available at: www.nhlbi. nih.gov. Partinen, M., McNicholas, T. (1998). Epidemiology, morbidity and mortality of the sleep apnoea syndrome. European Respiratory Monograph, 10, 63-74.
• Sanders, M.H., Newman, A. B., Haggerty, C. L., Redline, S., Lebowitz, M., Samet, J., et al. (2003). Sleep and sleep-disordered breathing in adults with predominantly mild obstructive airway disease. Am J Respir Crit Care Med, 167(1), 7–14.
• Sateia, M. J. (2014). International classification of sleep disorders. Chest, 146(5), 1387–1394.
• Sforza, E., Petiau, C., Weiss, T., Thibault, A., Krieger, J. (1999). Pharyngeal critical pressure in patients with obstructive sleep apnea syndrome. Clinical implications. Am J Respir Crit Care Med, 159(1), 149–157.
• Shigehara, K., Konaka, H., Sugimoto, K., Nohara, T., Izumi, K., Kadono, Y., et al. (2018). Sleep disturbance as a clinical sign for severe hypogonadism: Efficacy of testosterone replacement therapy on sleep disturbance among hypogonadal men without obstructive sleep apnea. Aging Male, 21(2), 99–105.
• Soriano, J. B., Yanez, A., Renom, F., Pena, M., Gomez, A., Duro, R., et al. (2010). Set-up and pilot of a population cohort for the study of the natural history of COPD and OSA: The ULSAIB study. Prim Care Respir J, 19(2), 140–147.
• Taken, K., Ekin, S., Arısoy, A., Günes, M., Dönmez, M. İ. (2016). Erectile dysfunction is a marker for obstructive sleep apnea. Aging Male, 19(2), 102–105.
• Tezcan, S., Seçkiner, P. (2012). Türkiyedeki demografik değişim, yaşlı perspektifi. İçinde: Yaşlı sağlığı: Sorunlar ve çözümler. Editörler, Aslan D, Ertem M. Hasuder yayın no: 2012.
• Tishler, P. V., Larkin, E. K., Schluchter. M. D., Redline, S. (2003). Incidence of sleepdisordered breathing in an urban adult population. JAMA, 289(17), 2230–2237.
• Young, T., Shahar, E., Nieto, F. J., Redline, S., Newman, A. B. D. J., Gottlieb, et al. (2002). Predictors of sleep-disordered breathing in community dwelling adults: The Sleep Heart Health Study. Arch Intern Med, 162, 893-900.
• Yu, C. C., Huang, C. Y., Kuo, W. K. C., Hen, C. Y. (2019). Continuous positive airway pressure improves nocturnal polyuria in ischemic stroke patients with obstructive sleep apnea. Clin Interv Aging, 14, 241–247.