0733 The Association of Nocturia and Napping with Obstructive Sleep Apnea Among Older Adults with Insomnia and/or Daytime Sleepiness

Abstract

Abstract Introduction Obstructive sleep apnea (OSA) is underdiagnosed in older adults (OAs) due to the poor performance of screening questionnaires. Symptoms of nocturia and napping may improve the identification of OSA in this population. We examined the association of these symptoms with OSA in OAs, and whether the association differed by gender. Methods In a prospective, observational study among 39 community-living adults ≥ 65 years reporting symptoms of insomnia and/or daytime sleepiness ≥once/week, we evaluated the association of nocturia and napping with OSA. Nocturia was assessed by the self-reported average number of times getting up to urinate at night. Napping was evaluated by self-reported number of naps/week, average nap duration (in minutes), and napping minutes/week (naps/week x minutes/nap). OSA was assessed by the Apnea Hypopnea Index (AHI) from home-based polysomnography. We used Pearson correlation coefficients to examine the strength of the association of nocturia and napping with AHI among all subjects, and separately in men and women. Results In all participants, the mean age was 74+/- 6.8 years, 72% were women, and the mean AHI was 19+/- 15.9 events/hr. When compared to women, men reported more nocturia (1.6 vs.1.3 episodes/night), more napping (including naps/week [3 vs. 2], nap duration [31 vs.17 minutes], and napping minutes/week [150vs. 55 minutes]). In addition, they had higher AHIs (25 vs.16 events/hr). Among all participants, nocturia was not significantly correlated with AHI, while nap duration and napping minutes/week were significantly correlated with AHI (p values < 0.02). Among 11 men, nap duration and minutes per week were correlated with AHI (correlations 0.74 [p=0.009] and 0.56 [p=0.07], respectively). Among women, no napping characteristics were significantly correlated with AHI. Conclusion Among community-dwelling OAs with insomnia and daytime sleepiness, napping, and not nocturia, was associated with OSA. This association was driven by the strong correlation among men, particularly for nap duration. Napping may be a good screening question for OSA in older men, but examination of other symptoms is warranted in older women. Support (if any) Claude D. Pepper Older Americans Independence Center at Yale School of Medicine (P30AG021342), the Robert E. Leet and Clara Guthrie Patterson Trust, and the National Institute on Aging (R03AG073991, K76AG074905).