Associations of the Severity of Obstructive Sleep Apnea With Age-Related Comorbidities: A Population-Based Study

Abstract

Aging is accompanied by changes in the quantity and quality of sleep. Obstructive sleep apnea (OSA) is also more prevalent in the older population. Although severe OSA has been linked to a higher risk of cardiovascular disease regardless of adult age, clinical consequences of mild-to-moderate OSA in the older adults are still uncertain.ObjectivesTo investigate the relationships between severity and metabolic, cognitive, and functional characteristics in community-dwelling older adults from a representative sample of the city of São Paulo.MethodsIn total, 199 participants of the first follow-up of the São Paulo Epidemiologic Sleep Study (EPISONO, São Paulo, Brazil) >60 years were cross-sectionally assessed through questionnaires, physical evaluations, laboratory tests, and full in-lab polysomnography (PSG). Three groups according to the OSA severity were compared according to sociodemographic characteristics, anthropometric measures, PSG parameters, the frequency of comorbidities, and the use of medications.ResultsParticipants' age ranged from 60 to 87 years with a mean of 70.02 ± 7.31, 59.8% female. In the univariate analysis, body mass index (BMI, kg/m2) (p = 0.049) and waist circumference (p = 0.005) were significantly higher in the participants with moderate OSA, but not among those with severe OSA. Participants with severe OSA had a higher arousal index (p = 0.007). Multivariate analysis showed that severe OSA was significantly associated with hypertension (p = 0.005), heart diseases (p = 0.025), and the use of two or more medications (p = 0.035).ConclusionIn a population-based study, severe, but not mild-to-moderate, OSA in older adults was associated with hypertension and the use of more medications. As age advances, anthropometric indicators of obesity may not increase the risk of severe OSA.

A Systematic Review of Risk factors for Sleep Apnea

“…These changes can lead to airway collapse, contributing to the development or worsening of sleep apnea ( Pham and Schwartz, 2015 ). The comorbidities increase the risk of developing sleep apnea in elderly ( Silva et al, 2022 ). Identifying risk factors for sleep apnea is of particular importance for the diagnosis of sleep apnea in the elderly ( Quinnell and Smith, 2004 ).…”

Associations Between Sleep Quality and Metabolic Syndrome in a Brazilian Population: A Primary and Cross-Sectional Study

“…Modernity has brought many benefits and facilities to human life, but it was also accompanied by lifestyle changes such as reducing physical exercise and changing eating habits, contributing to the increase in the prevalence of cardiovascular diseases (CVD) and other metabolic disorders. The prevalence of sleep disorders has also increased, and many studies have found relationships between CVD, metabolic disorders, and sleep quality [1][2][3][4] .…”