Effects of Age on Sleep Apnea in Men

Bixler, Edward O.; Vgontzas, Alexandros N.; Have, Thomas Ten; Tyson, Kathy; Kales, Anthony

doi:10.1164/ajrccm.157.1.9706079

Cited by 1,104 publications

(833 citation statements)

References 27 publications

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“…Young 29 has previously suggested an heuristic model with sleep apnoea as both an age related disorder seen at lower ages and an age dependent condition in the elderly, with a potential overlap in the 60-70 year age range. This hypothesis was supported by the results of a population based study of the prevalence and severity of OSAS in men aged 20-100 years by Bixler et al 30 who found that the prevalence of sleep apnoea tended to increase with age. On the other hand, the maximum prevalence of OSAS, defined as an AHI of >10 and the presence of daytime symptoms, was in the middle age group (45-64 years).…”

Section: Discussionmentioning

confidence: 70%

Prevalence of sleep apnoea and snoring in hypertensive men: a population based study

Sjöström

Lindberg²,

Elmasry³

et al. 2002

Thorax

120

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Background: Several studies have reported an association between sleep disordered breathing (SDB) and hypertension (HT) but there is still a debate as to whether this is an effect of confounders. Some researchers have found an age dependent relationship between SDB and HT with higher risk at lower ages. A case-control study was performed in hypertensive men and non-hypertensive male controls matched for age and body mass index to assess whether there is an independent association between SDB and HT. If so, we further wanted to investigate whether this effect is age dependent. Methods: An overnight sleep study was performed in a population based, age stratified sample of 102 hypertensive men aged 43-82 years and 102 non-hypertensive controls. Results: Hypertensive subjects had a significantly higher prevalence of SDB than non-hypertensive subjects (apnoea-hypopnoea index (AHI): 10.8 v 7.3; desaturation index (DI): 8.5 v 5.2; AHI >10: 37% v 24%, p<0.05; DI >10: 29% v 12%; lowest desaturation: mean (SD) 81.9 (7.3) v 84.7 (6.1), p<0.01). After adjusting for neck circumference and physical inactivity, DI >10 and lowest desaturation were still independent predictors of HT with adjusted odds ratios of 2.3 (95% CI 1.0 to 5.3) and 0.94 (95% CI 0.89 to 0.99), respectively. When the subjects were split into two groups according to age (<60 and >60 years), the influence of DI >10 on HT was strongest in the younger men (adjusted OR 4.3 (95% CI 1.0 to 19.3 v 2.1 (95% CI 0.7 to 6.5)) and the association between minimum oxygen saturation (SaO 2 ) and HT reached statistical significance in the younger men only. Conclusion: SDB is more prevalent in men with HT than in controls. DI >10 and lowest desaturation are independent predictors of HT irrespective of confounders. The results indicate that the influence of SDB on HT is more pronounced in younger and middle aged men than in those above 60 years.

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Section: Discussionmentioning

confidence: 70%

Prevalence of sleep apnoea and snoring in hypertensive men: a population based study

Sjöström

Lindberg²,

Elmasry³

et al. 2002

Thorax

120

View full text Add to dashboard Cite

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“…Secondly, despite a wide spectrum of SDB being present in the current population, mild cases were prevalent, the absence of severe cases may reduce the relationship between CRP and AHI. However, this finding is common in clinical and epidemiological studies; severe cases are more common in young patients [48]. Thirdly, the examined elderly subjects were noninstitutionalised and therefore they might constitute a survivor group more resistant to vascular risk and stress.…”

Section: Discussionmentioning

confidence: 93%

Association between C-reactive protein and unrecognised sleep-disordered breathing in the elderly

Roche¹,

Jm²,

Pichot³

et al. 2009

Eur Respir J

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Elevated levels of C-reactive protein (CRP) have been reported in patients with sleep-disordered breathing (SDB) and may represent an inflammatory marker of cardiovascular risk. However, the association of CRP with SBD in presumed healthy elderly subjects is unknown.In total, 851 (58.5% females) 68-yr-old subjects, who were free of any known cardiac or sleep disorders, were prospectively examined. Subjects underwent unattended polygraphy, and the apnoea/hypopnoea index (AHI) and oxyhaemoglobin desaturation index (ODI) were assessed. Elevated levels of CRP were found on the morning after the sleep study in patients with more severe SDB. A significant correlation was found between CRP levels, time spent at night with arterial oxygen saturation ,90% and ODI. No association was found between CRP levels and AHI. After adjustments for body mass index, smoking status, hypertension, diabetes and dyslipidaemia, a significant association remained between CRP levels and ODI .10 events?h -1 .CRP levels were frequently increased in a large sample of elderly subjects free of major cardiovascular disease. CRP levels were not correlated with the AHI and the indices of sleep fragmentation; the ODI .10 events?h -1 was the strongest predictor of raised CRP level.The present results suggest that, in the elderly, intermittent hypoxaemia may underlie inflammatory processes leading to cardiovascular morbidity. KEYWORDS: C-reactive protein, elderly, hypoxaemia, inflammation, sleep apnoea O bstructive sleep apnoea syndrome (OSAS) is a highly prevalent disorder affecting 2-4% of the general population and is considered an independent risk factor for cardiovascular diseases [1-3], particularly hypertension, coronary artery disease, heart failure and stroke [4,5]. Furthermore, newly diagnosed OSAS patients, free of classical cardiovascular risk factors, such as hypertension, diabetes and smoking, may have early signs of atherosclerosis [6]. Although the pathophysiology of cardiovascular risk is mutifactorial, sympathetic hypertonia [7], endothelial dysfunction [8, 9] and insulin resistance [10] have been postulated as factors initiating and sustaining inflammatory microvascular alterations and therefore atherosclerosis [11,12]. In middle-aged OSAS patients, C-reactive protein (CRP), a marker of inflammation in atherosclerotic lesions [13], is elevated in severe cases [14] and decreases after treatment with nasal continuous positive airway pressure [15]. Despite the putative role of CRP in cardiovascular risk in OSAS, studies conducted to date have yielded contradictory results, with some showing an independent association with disease severity in adults [16][17][18][19] and children [20,21], and others showing no relationship [22,23]. Moreover, the association between obesity and CRP [24] raised the question as to whether elevated CRP reflects the effects of obesity or whether it is specific to OSAS itself.In the elderly, the prevalence of sleep-disordered breathing (SDB) is estimated to be higher than in middle-aged subjects. AN...

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“…De acordo com pesquisas já realizadas, o ronco tende a aumentar com a idade (6,11). Estudos direcionados à prevalência foram realizados em uma população de homens e mulheres com idade entre 20 e 100 anos, os quais foram separados em subgrupos e apresentaram como resultado a maior prevalência de ronco em mulheres acima de 65 anos e nos homens entre 45 e 64 anos (26,27). …”

Section: Gráfico 1 -Gênero E Pontuação Média Na Escala De Epworthunclassified

Intervenção fisioterapêutica em adultos roncadores

2010

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ResumoIntrodução: O ronco é caracterizado como o som emitido pela vibração dos tecidos moles da faringe, por causa da dificuldade que o ar encontra ao passar pela via aérea superior com obstrução parcial. Objetivo: Analisar a eficácia da intervenção fisioterapêutica em adultos roncadores, atendidos na clínica-escola de Fisioterapia da Universidade do Sul de Santa Catarina (Unisul). Método: Trata-se de uma pesquisa explicativa, quantitativa e quase experimental. Na primeira fase, a amostra foi composta por sete indivíduos residentes da cidade de Tubarão e na segunda fase três participantes fizeram parte da intervenção fisioterapêutica. Os dados foram tratados com estatística descritiva (média e desvio-padrão), inferencial (teste de wilcoxon com p < 0,05) e correlação de Pearson. Resultados: Na primeira fase, relacionando a Escala de Epworth com as variáveis analisadas, as mulheres apresentaram maior propensão ao sono, os indivíduos acima de 50 anos e com IMC > 25 apresentaram maior sonolência excessiva diurna e a qualidade de vida foi menor em indivíduos com maior pontuação na escala. Nos resultados pré e pós-intervenção fisioterapêutica, descritos na segunda fase, dois indivíduos diminuíram a pontuação na Escala de Epworth e um aumentou, houve aumento na pontuação de SF36 relacionado à qualidade de vida, dois indivíduos aumentaram o IMC e um diminuiu, sendo que todos os participantes diminuíram a circunferência do pescoço e a protusão de cabeça. Conclusão: A fisioterapia pode proporcionar bons resultados no tratamento do ronco, contribuindo com a diminuição da sonolência excessiva diurna e melhora da qualidade de vida. Palavras

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Effects of Age on Sleep Apnea in Men

Cited by 1,104 publications

References 27 publications

Prevalence of sleep apnoea and snoring in hypertensive men: a population based study

Prevalence of sleep apnoea and snoring in hypertensive men: a population based study

Association between C-reactive protein and unrecognised sleep-disordered breathing in the elderly

Intervenção fisioterapêutica em adultos roncadores

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