Sleep disordered breathing at the extremes of age: the elderly

McMillan, Alison; Morrell, Mary J.

doi:10.1183/20734735.003216

Cited by 65 publications

(47 citation statements)

References 115 publications

(113 reference statements)

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“…Numerous studies have linked EDS to cognitive decline, and those with EDS are more likely to be regular nappers . Sleep‐disordered breathing (SDB) is also prevalent among older people and commonly causes DS. Although significant associations between napping characteristics and cognitive performance remained after adjusting for age, gender, self‐reported BMI, and DS (risk factors for SDB), we cannot rule out the possibility that SDB is driving our results.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous studies have linked EDS to cognitive decline, [30][31][32] and those with EDS are more likely to be regular nappers. 5 Sleep-disordered breathing (SDB) is also prevalent among older people 33 This is a limitation in light of evidence supporting SDB as a potential cause of mild cognitive impairment and dementia. 34 Alternatively, napping may be a marker of neurodegenerative disease.…”

Section: Discussionmentioning

confidence: 99%

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Napping characteristics and cognitive performance in older adults

Owusu

Wennberg

Holingue

et al. 2018

Int J Geriat Psychiatry

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Objectives: To determine the association of napping intention, frequency, and duration with cognition in a nationally-representative sample of U.S. older adults. Methods: We performed a cross-sectional analysis of community-dwelling Medicare beneficiaries aged ≥65 years from Rounds 3 or 4 (2013–2014) of the National Health and Aging Trends Study (N=2,549). Participants reported past-month napping intention (intentional/unintentional), napping frequency (rarely/never [non-nappers], some days [infrequent nappers], most days/every day [frequent nappers]), and average nap duration (we categorized as ≤30 minutes [short]; 31–60 minutes [moderate]; and >60 minutes [long]). Cognitive outcomes were performance on immediate and delayed word recall tests (IWR and DWR, respectively), the Clock Drawing Test (CDT), and self-rated memory (score: 1[excellent]-5[very poor]). Results: After adjustment for potential confounders, unintentional nappers had poorer immediate word recall test performance than non-nappers (B=−0.23, p<0.01) and intentional nappers (B=−0.26, p<0.01). After further adjustment for daytime sleepiness, frequent nappers reported poorer self-rated memory than non-nappers (B=0.14, p<0.05). Compared to short nappers, long nappers had poorer IWR (B=−0.26, p<0.05) and CDT scores (B=−0.17, p<0.05). Except for the association of nap duration with IWR and CDT, these associations remained after excluding participants with dementia and/or proxy respondents. Among participants undiagnosed with dementia or proxies, moderate-duration naps were associated with better DWR than short naps (B=0.24, p<0.05). Neither napping intentionality nor frequency were associated with CDT performance. Conclusions: Among older adults, distinct aspects of napping are associated with cognitive performance. Prospective research, with objective measures of napping, is needed to elucidate the link between napping and cognitive trajectories.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Napping characteristics and cognitive performance in older adults

Owusu

Wennberg

Holingue

et al. 2018

Int J Geriat Psychiatry

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“…4,5,[7][8][9][10][11] A higher prevalence of OSA has been reported in patients aged >65 years than that in subjects aged 30-65 years. 12,13 Nonetheless, the aforementioned animal and human experimental IH studies have been exclusively performed in young, healthy adult rodents and humans, and the effect of CIH on aged experimental subjects has not yet been fully explored. The present study aimed to assess the role of ageing in the early cardiovascular structural remodelling induced by CIH in a murine model of OSA.…”

Section: Summary At a Glancementioning

confidence: 99%

“…A higher prevalence of OSA has been reported in patients aged >65 years than that in subjects aged 30–65 years . Nonetheless, the aforementioned animal and human experimental IH studies have been exclusively performed in young, healthy adult rodents and humans, and the effect of CIH on aged experimental subjects has not yet been fully explored.…”

Section: Introductionmentioning

confidence: 99%

Effect of age on the cardiovascular remodelling induced by chronic intermittent hypoxia as a murine model of sleep apnoea

et al. 2019

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Background and objective Chronic intermittent hypoxia (CIH) is a major determinant of the cardiovascular morbidity associated with obstructive sleep apnoea (OSA), and the magnitude of CIH impact may be influenced by ageing. Here, we assessed the role of ageing in the early cardiovascular structural remodelling induced by severe CIH in a murine model of OSA. Methods Cardiovascular remodelling was assessed in young (2 months old, n = 20) and aged (18 months old, n = 20) C57BL/6 female mice exposed to CIH (20% O2 for 40 s, 5% O2 for 20 s) or normoxia (room air) for 8 weeks (6 h/day). Results Early vascular remodelling was observed in young mice exposed to CIH as illustrated by intima‐media thickening (mean change: 4.6 ± 2.6 μm; P = 0.02), elastin fibre disorganization (mean change: 9.2 ± 4.5%; P = 0.02) and fragmentation (mean change: 2.5 ± 0.8%; P = 0.03), and collagen (mean change: 3.2 ± 0.6%; P = 0.001) and mucopolysaccharide accumulation (mean change: 2.4 ± 0.8%; P = 0.01). In contrast, vascular remodelling was not apparent in aged mice exposed to CIH. Furthermore, left ventricular perivascular fibrosis (mean change: 0.71 ± 0.1; P < 0.001) and hypertrophy (mean change: 0.17 ± 0.1; P = 0.038) were increased by CIH exposure in young mice, but not in aged mice. Principal component analysis identified similar cardiovascular alterations among the young mice exposed to CIH and both older mouse groups, suggesting that CIH induces premature cardiovascular senescence. Conclusion Cardiovascular remodelling induced by severe CIH is affected by the age at which CIH onset occurs, suggesting that the deleterious cardiovascular effects associated with CIH may be more pronounced in younger populations, and such changes resemble chronological age‐related declines in cardiovascular structural integrity.

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“…Prevalence of OSAS ncreases with age, with a conservative estimation of double the prevalence in younger age groups [6]. There are several mechanisms associated with this age-related increase, including reduction in pharyngeal muscle function, age-related differences in pharyngeal morphology (including a decrease in the size of the upper airway lumen), increase in arousal frequency that leads to periodic breathing, and increase in the prevalence of obesity andcomorbidities [including congestive heart failure and neurocognitive impairment (such as dementia and stroke)] [7].…”

Section: Introductionmentioning

confidence: 99%

Results of Polysomnographies and Treatment Strategies in Elderly Patients with Symptoms of Obstructive Sleep Apnea Syndrome

Balcan

Uğurlu

2017

Turk Thorac J

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OBJECTIVES:In this study, we evaluated data regarding the management of geriatric patients with symptoms of obstructive sleep apnea syndrome (age, >65 years) who were admitted to our sleep clinic. MATERIAL AND METHODS:Symptoms and sleep data of the patients were retrospectively evaluated, and the patients were reevaluated after treatment. RESULTS:A total of 85 patients with a median age of 69 years were included. Snoring and fatigue were the most common symptoms. Cardiovascular diseases were the most frequently listed comorbidity. The median Epworth sleepiness scale was 10, and based on Berlin sleep questionnaire findings, 63.5% of the participants were in the high-risk group. Eighty-seven percent were diagnosed with obstructive sleep apnea (2/3 of them were positional), and moderate-to-severe obstructive sleep apnea was observed more in women than in men. Only one patient was diagnosed with central sleep apnea. There were positive and linear correlations between increased age and the apnea-hypopnea index, arousal index, Epworth sleepiness scale, and being in a high-risk group according to the Berlin sleep scale; however, there was no correlation between increased age and the number of hypopnea and apnea events. There were also positive and linear correlations between the apnea-hypopnea index and the Epworth sleepiness scale, being in a high-risk group according to the Berlin sleep questionnaire, an increased number of known medical conditions, and increased body mass index. We were able to contact 72 of the 85 patients via phone calls. Patients who adjusted to treatment had positive feedbacks. CONCLUSION:Sleep disorders are observed more in the elderly, and an increasing age is an independent factor for sleep disorders. Besides the usual signs and symptoms of sleep disorders, it should be considered in elderly who have cognitive dysfunction and dementia. KEYWORDS: Elderly, polysomnography, obstructive sleep apnea INTRODUCTIONThe proportion of elderly people (age, >65 years) has been increasing, particularly in developing countries. The World Health Organization has estimated that the population of people aged >65 years will be 1.5 billion by 2050 [1]. Although some people age without having any serious illnesses, some elderly might have "pathological aging" with significant comorbidities that lead to functional impairment [2]. One way or another, the elderly may complain of changes in sleep habits such as difficulty falling asleep and maintaining sleep, with frequent nocturnal awakenings and early morning awakening; thus, sleep gets more fragmented and consequently lighter [3]. Because of the changes in sleep architecture or physiological and/or pathological changes owing to aging, elderly people may report increased daytime sleepiness and fatigue as well as concentration and memory problems [4]. These symptoms can also occur because of obstructive sleep apnea syndrome (OSAS), which is characterized by nocturnal episodes of upper airway obstruction, sleep fragmentations, and hypoxemia [5]. These symptoms might ...

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Sleep disordered breathing at the extremes of age: the elderly

Cited by 65 publications

References 115 publications

Napping characteristics and cognitive performance in older adults

Napping characteristics and cognitive performance in older adults

Effect of age on the cardiovascular remodelling induced by chronic intermittent hypoxia as a murine model of sleep apnoea

Results of Polysomnographies and Treatment Strategies in Elderly Patients with Symptoms of Obstructive Sleep Apnea Syndrome

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