Clinical Characteristics in Two Subgroups of Obstructive Sleep Apnea Syndrome in the Elderly Comparison Between Cases With Elderly and Middle-Age Onset
Clinical Characteristics in Two Subgroups of Obstructive Sleep Apnea Syndrome in the Elderly Comparison Between Cases With Elderly and Middle-Age Onset
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DOI：
10.1378/chest.09-2251
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发表时间：
2010-06-01
期刊：
影响因子：
9.6
通讯作者：
Inoue, Yuichi
中科院分区：
文献类型：
--
作者：
Kobayashi, Mina;Namba, Kazuyoshi;Inoue, Yuichi
背景：阻塞性睡眠呼吸暂停综合征（OSAS）的发病率在老年人群中增加。然而，老年OSAS患者的临床特征还没有得到最终的表征。本研究的目的是阐明中年发病的OSAS患者和老年发病的OSAS患者之间的临床特征的差异。方法：年龄≥ 65岁的OSAS患者根据首次识别睡眠呼吸暂停的年龄分为组：中年发病组（n = 32），其中发病年龄= 60岁。我们比较了人口统计学变量;多导睡眠图变量;日间嗜睡的措施，包括多次睡眠潜伏期测试（MPEST）和埃普沃思嗜睡量表（ESS）;和足够的水平，鼻持续气道正压通气（CPAP）groups.Results：BMI和潜在的心血管疾病的频率在老年发病组低于中年发病组。两组之间的呼吸暂停低通气指数或显示O-2去饱和期的百分比无显著差异。然而，唤醒指数，最大食管负压值，和足够的鼻CPAP水平在老年发病组显着较小。结论：与中年组相比，老年组OSAS的临床意义较轻。这一发现可能是因为对呼吸事件的生理反应较小。胸部2010; 137（6）：1310-1315
Background: Morbidity due to obstructive sleep apnea syndrome (OSAS) is increased in the elderly population. However, the clinical characteristics of OSAS in elderly patients have not been characterized conclusively. The aim of this study was to clarify differences in clinical characteristics of OSAS between patients with middle-age onset and elderly onset of OSAS.Methods: Patients with OSAS aged >= 65 years were classified into groups according to age at first identification of respiratory pauses during sleep: a middle-age onset group (n = 32) where onset was at age = 60 years. We compared demographic variables; polysomnographic variables; daytime sleepiness measures, including the multiple sleep latency test (MSLT) and the Epworth sleepiness scale (ESS); and adequate level of nasal continuous positive airway pressure (CPAP) between groups.Results: BMI and frequency of underlying cardiovascular disorder were lower in the elderly onset group than in the middle-age onset group. No significant differences in apnea-hypopnea index or percentage of the period showing O-2 desaturation were seen between groups. However, arousal index, maximal negative esophageal pressure value, and adequate nasal CPAP level were significantly smaller in the elderly onset group. Mean sleep latency on MSLT was longer, and ESS score was lower in the elderly onset group.Conclusions: Compared with the middle-age onset group, the clinical significance of OSAS in the elderly onset group seemed to remain milder. This finding is possibly because of the smaller physiologic response to respiratory events. CHEST 2010; 137(6):1310-1315