Obstructive Sleep Apnea And The Spectrum Beyond In The Elderly Patients

Abstract

Longer life expectancy in the elderly is a worldwide phenomenon observed during the last two decades owing to the improvements in socioeconomic status, better health policies and revolutionary efforts in imparting health awareness amongst the general public through print, visual and social media. This lead to the concept of “active aging†by maximizing the health and functional ability of older people to achieve disease and disability free quality living. Extensive studies have been performed to assess factors that may affect active aging, such as metabolic, vascular and neuropsychological factors, and sleep disorders, such as insomnia, Obstructive Sleep apnea hypopnea syndrome (OSAHS) and other sleep related breathing disorders (SRBD). However, OSAHS and SRBD remains under diagnosed despite the diagnostic and therapeutic advances in this field leading to the evolution of a new specialty of medicine, the sleep medicine. In middle-aged adults, snoring, excessive daytime sleepiness, poorly controlled hypertension, cerebrovascular diseases, depression, accelerated cognitive decline and traffic accidents should prompt screening and an evaluation for the possibility of an undiagnosed OSAHS. Although OSAHS in the elderly seems to have a lower impact on mortality than it does in middle-aged adults, the risk of stroke and new-onset hypertension appears to increase in elderly patients. In addition, the presence of central sleep apnea must prompt a thorough cardiac assessment, even in the elderly. Both elderly and middle-aged symptomatic OSA patients derive equivalent benefits from continuous positive airway pressure (CPAP) treatment.