Sleep related breathing disorder (SRBD) is associated with daytime sleepiness, hypertension, impaired cognitive function, increase in overall mortality and particularly cardiovascular mortality. Aging brings about a deterioration in sleep quality and increased prevalence of SRBD. Symptoms in the elderly are often confounded with normal aging processes leading to under-diagnosis of SRBD. The purpose of this study was to examine the prevalence of SRBD in an elderly population complaining of poor sleep.
Active subjects were recruited to a study examining the effect of yoga in elderly suffering of poor sleep. Subjects over age 60 were interviewed and screened by an experienced sleep physician, patients with suspected or diagnosed SBRD were excluded. Of 81 subjects 4 were excluded for medical conditions, 6 for sleep apnea and 2 subjects withdrew. 69 subjects underwent home sleep studies with an Embletta X30. Age was 74.7 ± 6.8, 81% were women, BMI was 25.6 ± 3.6. HC1000P software was used to analyze the sleep tests based on ECG and pulse wave signals. Sleep architecture, arousals, sleep efficiency and apnea/hypopnea index (AHI) were obtained. Final diagnosis was made by an expert based on clinical information and test results.
Of 69 subjects examined 39.1% were found to have an AHI greater than 15, 63.8% had an AHI greater than 10. No difference was found in age or BMI between healthy and affected subjects, men were more likely to suffer apnea than women. Only 11.6% were healthy.
88.4% of subjects, encompassing active elderly complaining of poor sleep, had undiagnosed mild SRBD or worse that was not predicted by clinical findings or questionnaires. This high incidence occurs in a woman predominant population with a multitude of medical problems (hypertension, heart disease, diabetes) and use of various sleep promoting medications. Efficient treatment of the SRBD in these patients should improve sleep quality, general health and function.
Since clinical evaluation is unreliable at this age, elderly should have simple, cost effective home diagnosis of their disorder, allowing for treatment, when needed.
Clement Cahan, Employee Dr Anda Baharav, Dr Shuli Eyal and Yair Fuxman are affiliated with HypnoCore Ltd, a medical device company specializing in dianosis of sleep disturbances. HC1000P, a HypnoCore product was used in the diagnosis of SBRD for this study.; No Product/Research Disclosure Information