Clinical Features and Polysomnographic Findings in Greek Male Patients with Obstructive Sleep Apnea Syndrome: Differences Regarding the Age

Efremidis George,Beroukas Lambros,Spyropoulou Maria,Georgopoulos Dimitrios,Nikoloutsou Konstantina,Varela Katerina

doi:10.1155/2012/324635

Abstract

Background-Aim. Although sleep disturbance is a common complaint among patients of all ages, research suggests that older adults are particularly vulnerable. The aim of this retrospective study was to elucidate the influence of age on clinical characteristics and polysomnographic findings of obstructive sleep apnea syndrome (OSAS) between elderly and younger male patients in a Greek population. Methods. 697 male patients with OSAS were examined from December 2001 to August 2011. All subjects underwent an attended overnight polysomnography (PSG). They were divided into two groups: young and middle-aged (<65 years old) and elderly (≥65 years old). We evaluated the severity of OSAS, based on apnea-hypopnea index (AHI), and the duration of apnea-hypopnea events, the duration of hypoxemia during total sleep time (TST) and during REM and NREM sleep, and the oxygen saturation in REM and in NREM sleep. Results. PSG studies showed that elderly group had significant higher duration of apnea-hypopnea events, longer hypoxemia in TST and in NREM sleep, as well as lower oxygen saturation in REM and NREM sleep than the younger group. Otherwise, significant correlation between BMI and neck circumference with AHI was observed in both groups. Conclusions. The higher percentages of hypoxemia during sleep and longer duration of apnea-hypopnea events that were observed in the elderly group might be explained by increased propensity for pharyngeal collapse and increased deposition of parapharyngeal fat, which are associated with aging. Another factor that could explain these findings might be a decreased partial arterial pressure of oxygen (PaO2) due to age-related changes in the respiratory system.

Highlights

Obstructive sleep apnea syndrome (OSAS) is a highly prevalent disorder characterized by instability of the upper airway during sleep, which results in markedly reduced or absent airflow at the nose/mouth [1]
There were no significant differences in baseline characteristics such as body mass index (BMI) and neck circumference among the two groups (Table 1)
There were no significant differences in BMI and apnea-hypopnea index (AHI) between the two age groups, but neck circumference and BMI were the most significant determinants of AHI in all patients based on the stepwise multiple regression analysis

Summary

Introduction

Obstructive sleep apnea syndrome (OSAS) is a highly prevalent disorder characterized by instability of the upper airway during sleep, which results in markedly reduced (hypopnea) or absent (apnea) airflow at the nose/mouth [1]. It is well known that there are differences of OSAS regarding the elderly [3]. Studies about the clinical characteristics of OSAS have been done mainly in middle-aged adults and there is little information on the differences in polysomnographic findings of OSAS between elderly and younger adults. A high prevalence of OSAS of 30.5% [4] up to 81% [3] was reported in the elderly (≥65 years old) when OSAS was defined as an apnea-hypopnea index (AHI) of more than 5 events per hour. In previous studies, body mass index (BMI)—one of the most typical parameters which correlates significantly with AHI in young patients with. The differences in clinical characteristics of OSAS between young or middle-aged and elderly patients are not fully explained

Methods

Results

Discussion