Clinical Characteristics In Two Subgroups Of Obstructive Sleep Apnea Hypopnea Syndrome In The Elderly

Objective To clarify differences in clinical characteristics betweenpatients with middle-age onset and elderly onset of OSAHS in the elderly,therefore to carry out individualized treatment.Methods From June2009to February2014, patients aged≥60years anddiagnosed with OSAHS by undertaking PSG in Sleep Disordered BreathingCenter of the People’s Hospital of Guangxi Zhuang Autonomous Region wereincluded. We excluded those patients underwent continue positive airwaypressure treatment, whose age at onset of respiratory disorder could not bedetermined objectively, such as living or sleeping alone, had a history ofcerebrovascular disorder, currently affected by heart failure or respiratory failure.The onset age was defined as age about first identification of respiratory pausesduring sleep. All the patients were classified into groups: an elderly onset groupwhere onset was at age≥60years and a middle-age onset group where onsetwas at age <50years. Clinical symptoms, comorbidities and PSG findings were compared.Results A total of342patients were included, there were207patients inelderly onset group,135patients in middle-age onset group. The patients in theelderly onset group had lower AHI(26.84±17.4/h VS32.12±21.34/h, p<0.05),lower ESS score(7.41±4.78VS9.18±5.46, p<0.05), and lower frequency ofnocturia (50(24.20%) VS51(37.80%), p<0.05), but frequency of underlyingmyocardial infarction (30(14.50%) VS7(5.20%), p<0.05) was higher in theelderly onset group, no differences were found in frequency of hypertension.Multiple factor analysis showed that the differences in AHI, ESS score andfrequency of nocturia between this two groups remained significantly, theelderly onset group had lower AHI(B=-5.067, p<0.05), lower ESSscore(B=-1.728, p<0.05) and lower risk of nocturia(OR=0.425, p<0.05); thedifferences in prevalence of myocardial infarction were no longer significant.Conclusion Clinical characteristics in two subgroups of obstructivesleep apnea hypopnea syndrome in the elderly are different, compared with themiddle-age onset group, the severity of OSAHS, daytime sleepiness andfrequency of nocturia remain milder. It is proposed to distinguish the middle-ageonset OSAHS group from elderly onset OSAHS group and individualizedtreatment should be taken.