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Prevalence of Sleep Associated Alveolar Hypoventilation in an Elderly Population Presenting for Evaluation of a Sleep Complaint FREE TO VIEW

Richard Bogan, MD; Jo Anne Turner, MN
Author and Funding Information

SleepMed, Inc, Columbia, SC

Chest. 2011;140(4_MeetingAbstracts):966A. doi:10.1378/chest.1112111
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PURPOSE: In a group of adult patients 65 years or older presenting for sleep evaluation with polysomnography (PSG), prevalence of sleep induced alveolar hypoventilation with hypoxemia (AH) and obstructive apnea (OSA) are examined, demographics reviewed and the degree of sleepiness reported.

METHODS: Records of 42513 individuals undergoing baseline PSGs from 2009-2010 at SleepMed were reviewed. ESS was administered prior to each study. Two patient groups of sleep disordered breathing (SDB) were compared. AH group included RDI <10, nadir O2 < 85%, ODI <10 and time below 90% = > 10 minutes. The obstructive apnea group (OSA) included RDI >15 without regard to ODI. Oxygen desaturation index (ODI) was measured at equal to or greater than the 4%. Epworth Sleepiness Scale (ESS) is a validated tool measuring excessive daytime sleepiness (EDS).

RESULTS: Of 22151 men studied 4853(22%) were 65 years or older. Of the 4853 men, 3342 (69%) were identified to have SDB (AH+OSA=SDB). Of 21362 women studied 4796 (22%) were 65 or older. Of the 4796 women, 2682 (56%) were identified to have SDB. As a group of the 9649 there were 6024 total (62%) with SDB. AH group accounted for 597/9649 (6%) of the elderly adults studied and 597/6024 SDB (10%). Men (n=213, 36%) with AH were characterized by a mean age of 71(5); BMI 30(5); ESS 9(5); RDI 6.6(2); nadir O2 sat 80(5); time<90% minutes 91(91); ODI 4(2). Women (n=384, 64%) with AH were characterized by a mean age of 72(6); BMI 32(8); ESS 8(5); RDI 6(3); nadir O2 sat 80(4); time<90% minutes 98(95); ODI 4(2.5). AH/SDB= 6% in men and 14% in women. OSA accounted for 5427/9649 (56%) of the total studied and 5427/6024 SDB (90%). Men (n=3129, 58%) with OSA were characterized by a mean age of 72(6), BMI 31(10); ESS 9.5(5); RDI 39(21); nadir O2 sat 80(7); time < 90% minutes 45(62); ODI 24(19). Women with OSA (n=2298, 42%) were characterized by a mean age of 73(6); BMI 33(8); ESS 9.0(5); RDI 35(20); nadir O2 sat 80(8); time<90% minutes 50(69); ODI 22(18). OSA/SDB = 94% in men and 86% in women.

CONCLUSIONS: 62% of elderly adults presenting for PSG had clinically relevant SDB. 6% of elderly individuals studied by PSG met criteria for sleep induced hypoxemia. This represented 10% of SDB group. Women had a disproportionately higher prevalence of AH (14% vs. 6%), were slightly heavier by BMI, and mean ESS scores were slightly lower. ESS trended lower in AH group.

CLINICAL IMPLICATIONS: Identification of correlates of sleep hypoventilation and hypoxemia will assist the clinician in diagnosis of the disorder.

DISCLOSURE: Richard Bogan: Shareholder: SleepMed, inc., Consultant fee, speaker bureau, advisory committee, etc.: Speaker Bureau: Jazz, Cephalon, Sunovion, Consultant fee, speaker bureau, advisory committee, etc.: Consultant: Cephalon. Jazz, Sunovion, UCB, GSK, ApniCure

Jo Anne Turner: Consultant fee, speaker bureau, advisory committee, etc.: Speaker Bureau: Cephalon, Sunovion, Pfizer, and Somaxson

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01:30 PM - 02:45 PM




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