Sleep Disordered Breathing with Excessive Daytime Sleepiness is a Risk Factor for Mortality in Older Adults

Abstract

The presence of SDB is an important risk factor for mortality from excessive daytime sleepiness in older adults. In the presence of SDB at an AHI ≥20 events/h, EDS was associated with an increased all-cause mortality risk in older adults, even when adjusting for other significant risk factors, such as prolonged sleep duration. In older patients who had SDB without EDS, or EDS without SDB, there was no increased all-cause mortality rate.

Sleep apnoea is associated with major cardiac events in peripheral arterial disease

“…However, this can be considered an advantage since we were able to show the effect of OSA on outcome with fewer confounding factors. In line with previous literature, we used an AHI o20 events?h -1 as a cut-off level, which corresponds closely to the mean and median AHI observed in this study [16,27]. However, we were unable to demonstrate a continuous trend between the increase in AHI and the risk of MACCE.…”

“…the study sample was divided into patients with AHI 0-10 events?h -1 , 10-20 events?h -1 , 20-30 events?h -1 and .30 events?h -1 ; the latter three groups were compared to the first. According to these analyses and previous literature, AHI o20 events?h -1 was finally used as a threshold for significant OSA [16,27]. The differences between patients with AHI ,20 events?h -1 and AHI o20 events?h -1 were tested using the Mann-Whitney U-test for continuous variables and Fisher's exact test for categorical variables.…”

“…Before a large-scale screening for OSA in surgical PAD patients can be justified, an efficient treatment intervention improving the outcome of these patients should be investigated. Mounting evidence shows that CPAP prevents fatal and non-fatal cardiovascular events in patients with severe OSA [16,27,31,32]. However, the efficacy of CPAP treatment in surgical PAD patients with OSA remains to be established.…”

“…It has been stated that OSA combined with other risk factors has an incremental role in this pathophysiological cascade [12]. Finally, OSA is associated with the progression of atherosclerotic disease along with both fatal and non-fatal cardiovascular events [13][14][15][16].…”

Sleep apnoea syndrome in 2011: current concepts and future directions

“…An age limit is likely to be insufficient to adequately characterise the populations. Other characteristics may be important, as suggested by a recent study demonstrating that the presence of SDB in the setting of excessive daytime sleepiness appears to be a significant mortality risk factor in older adults [184]. Overall, with the remarkable exception of ischaemic heart disease, the typical morbidity associated with sleep apnoea in younger adults is found in the elderly.…”