Coincidence of obstructive sleep apnea syndrome and systemic diseases in geriatric patients

Year 2020, Volume: 4 Issue: 3, 247 - 253, 29.10.2020

Mehmet Akdağ , Aslı Bostancı Murat Turhan Oktay Dinç

https://doi.org/10.30565/medalanya.736684

Abstract

Aim: To evaluate the coincidence of obstructive sleep apnea syndrome (OSAS) and systemic diseases in elderly patients presenting to our sleep disorders center.

Patients and Methods: Ninety-seven patients with ages older than 65 years, who had at least one of snoring, witnessed apnea, and excessive daytime sleepiness symptoms, and whose systemic diseases were under evaluation, were included in the study. The patients were divided into 4 groups according to their apnea-hypopnea indexes (AHI) and body mass index (BMI) values. The association of BMI and the polysomnography parameters such as AHI, arousal index, lowest oxygen saturation and mean oxygen desaturation in patients with and without systemic illnesses ,were evaluated.

Results: Seventy-one (73.2%) of the patients comprised the group with systemic illnesses, and 26 (26.80%) patients comprised the group without systemic illnesses. AHI value was found to be higher in patients with systemic diseases compared to patients without systemic illnesses, and this was statistically significant (p<0.05). A statistically significant association was found between the presence of systemic diseases and OSAS and increased BMI (BMI>25) (p<0.05). A statistically significant association was not detected between the arousal index, lowest oxygen saturation, mean oxygen saturation, and presence of systemic illness. No difference in the rates of presence of systemic illnesses was found among male and female patients.

Conclusion: Patients in the geriatric age group with increased BMI and OSAS should be evaluated for the presence of systemic illnesses.

Keywords

Obstructive sleep apnea syndrome, systemic diseases, geriatrics

Supporting Institution

-

Project Number

-

Geriatrik Hastalarda Obstruktif Uyku Apne Sendromu Ve Sistemik Hastalık Birlikteliği

Abstract

Amaç: Uyku bozuklukları merkezimize başvuran yaşlı hastalardaki obstruktif uyku apne sendromu (OSAS) ile sistemik hastalık birlikteliğini ve bunlarla ilişkili parametreleri araştırmaktır

Hastalar ve Yöntem: Horlama, tanıklı apne, gündüz aşırı uyku hali semptomlarından en az birinden şikayeti olan ve sistemik hastalıkları araştırılan 65 yaş üstü 97 hasta çalışmaya alındı. Hastalar apne hipopne indeksi (AHİ) ve vücut kitle indeksi (VKİ) değerlerine göre 4'er gruba ayrıldı. Sistemik hastalığı olan ve olmayan hastalarda VKİ ile polisomnografi parametrelerinden AHİ, arousal indeksi, en düşük oksijen saturasyonu ve ortalama oksijen desaturasyonu arasındaki ilişki incelenmiştir.

Bulgular: Hastaların 71’i (%73.2) sistemik hastalığı olanlar, 26’sı (%26.80) sistemik hastalığı olmayanlar grubunu oluşturmuştur. Sistemik hastalığı olanlarda, sistemik hastalığı olmayanlara göre AHİ değeri daha yüksek saptanmış olup istatiksel olarak anlamlı saptanmıştır(p<0.05). Sistemik hastalık varlığı ile OSAS ve artmış VKİ (VKİ>25) arasında istatiksel olarak anlamlı birliktelik saptanmıştır(p<0.05). Arousal indeksi, en düşük oksijen saturasyonu ,ortalama oksijen desaturasyonu ile sistemik hastalık varlığı arasında istatiksel anlamlı bir birliktelik saptanmamıştır. Kadın ve erkek hastalar arasında sistemik hastalık görülmesi açısından fark saptanmamıştır.

Sonuç: Artmış VKİ ve OSAS’ı olan geriatrik yaş gurubundaki hastalar sistemik hastalık varlığı açısından değerlendirilmelidir.

Keywords

Obstruktif uyku apne sendromu, sistemik hastalık, geriatri

Project Number

-

References

• 1. Espiritu JR. Aging-Related Sleep Changes. Clin Geriatr Med.2008 Feb;24(1):1-14 (PMID: 18035227) DOI: 10.1016/j.cger.2007.08.007
• 2. Kim WJ, Joo WT, Baek J, et al. Factors associated with insomnia among the elderly in a korean rural community. Psychiatry Investig 2017;14:400-406. DOI:10.4306/pi.2017.14.4.400
• 3. Barthlen GM. Sleep disorders. Obstructive sleep apnea syndrome, restless legs syndrome, and insomnia in geriatric patients. Geriatrics. 2002 Nov;57(11):34-9; quiz 40. (PMID:12442567)
• 4. Martin J, Stepnowsky CJ, Ancoli-Israel S. Sleep apnea in the elderly.In: McNicholas WT, Phillipson EA (eds). Breathing disorders in sleep WB Saunders Philadelphia 2002:278-287.
• 5. Teramoto S, Matsuse T, Fukuchi Y. Clinical significance of nocturnal oximeter monitoring for detection of sleep apnea syndrome in the elderly. Sleep Med. 2002 Jan;3(1):67-71. (PMID:14592257)
• 6. Guilleminault C. Obstructive sleep apnea syndrome. A review. Psychiatr Clin North Am. 1987 Dec;10(4):607-21. (PMID:3332320)
• 7. Shizuku H, Hori Y, Uemura T, Nakagawa H, Matsuda K, Kalubi B et al. Combination of Bernouilli effect producing maneuver-induced pharyngeal narrowing rate with body mass index as predictive tool for obstructive sleep apnea syndrome. Acta Otolaryngol 2008 May; 128:569-573. (PMID:18421613)
• 8. Fairbanks D, Mickelson S, Woodson T. Coleman JA. Pathophyology of snoring and sleep apnea: airway dynamics. In Snoring and Obsturictive Sleep Apnea. Lippincot Williams & Wilkins Philadelphia 2003;Chapter 2:19-25.
• 9. Patil SP, Schneider H, Schwartz AR, Smith PL. Adult obstructive sleep apnea: pathophysiology and diagnosis. Chest 2007 Jul; 132(1):325-337. (PMID: 17625094)
• 10. Sullivan CE, Issa FG, Berthon-Jones M, Eves L. Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares. Lancet. 1981 Apr 18;1(8225):862-5. (PMID: 6112294)
• 11. American Academy of Sleep Medicine. The AASM Manuel for the Scoring of Sleep and Associated Events.2007.
• 12. World Health Organization Global Database on Body Mass Index-The International Classification of adult underweight, overweight and obesity according to BMI.2004
• 13. Köktürk O, Tatlıcıoglu T, Kemaloğlu Y et al. Habituel horlaması olan olgularda obstrüktif sleep apne sendromu prevalansı. Tüberküloz ve Toraks 1997; 45:7-11.
• 14. Martin J, Stepnowsky CJ, Ancoli-Israel S. Sleep apnea in the elderly.In: McNicholas WT, Phillipson EA (eds). Breathing disorders in sleep WB Saunders Philadelphia 2002:278-287.
• 15. Ancoli-Israel S, Gehrman P, Kripke DF, Stepnowsky C, Mason W, Cohen-Zion M et al. Long-term follow-up of sleep disordered breathing in older adults. Sleep Med. 2001 Nov;2(6):511-6. (PMID: 14592266)
• 16. Gottlieb DJ, Yenokyan G, Newman AB, O’Connor GT, Punjabi NM, Quan SF et.al. Prospective Study of Obstructive Sleep Apnea and Incident Coronary Heart Disease and Heart Failure: The Sleep Heart Health Study. Circulation. 2010 Jul 27;122(4):352-60 DOI:10.1161/CIRCULATIONAHA.109.901801.
• 17. Phillips CL, O'Driscoll DM. Hypertension and obstructive sleep apnea. Nat Sci Sleep 2013; 5:43-52 (PMID: 23750107)
• 18. Wassertheil-Smoller S, Anderson G, Psaty BM, Black HR, Manson J, Wong N et al. Hypertension and its treatment in postmenopausal women: baseline data from the Women's Health Initiative. Hypertension. 2000 ;36(5):780-9 (PMID: 11082143)
• 19. Ho PJ, Ho PJ, Turtle JR. Establishing the Diagnosis in Diabetes in Old Age. In: Sinclair AJ, Finucaine P (eds). 2nd ed.London. Wiley 2001: 25-39. DOI: 10.1002/0470842326.ch3
• 20. Mannino DM, Homa DM, Akinbami LJ, Ford ES, Redd SC. Chronic obstructive pulmonary disease surveillance-United States, 1971-2000. MMWR Surveill Summ. 2002 Aug 2;51(6):1-16. (PMID: 12198919)
• 21. Roberts RE, Shema SJ, Kaplan GA, Strawbridge WJ. Sleep complaints and depression in an aging cohort: A prospective perspective Am J Psychiatry.2000 Jan;157(1):81-8. (PMID: 10618017)
• 22. Reynolds CF 3rd, Buysse DJ, Kupfer DJ.Treating insomnia in older adults: taking a long-term view. JAMA 1999; 281(11):1034-1035. DOI: 10.1001/jama.281.11.1034
• 23. Vgontzas AN, Papanicolaou DA, Bixler EO, Hopper K, Lotsikas A, Lin HM et al. Sleep apnea and daytime sleepiness and fatigue: relation to visceral obesity, insulin resistance, and hypercytokinemia. J Clin Endocrinol Metab. 2000 Mar;85(3):1151-8. (PMID: 10720054)
• 24. Hora F, Napolis LM, Daltro C, et al. Clinical, anthropometric and upper airway anatomic characteristics of obese patients with obstructive sleep apnea syndrome. Respiration 2007;74:517-24 doi: 10.1159/000097790. Epub 2006 Dec 5.