The prevalence of obstructive sleep apnea-hypopnea syndrome-related symptoms and their relation to airflow limitation in an elderly population receiving home care

Abstract

Christos F Kleisiaris,1 Evangelos I Kritsotakis,2 Zoe Daniil,3 Nikolaos Tzanakis,4 Agelos Papaioannou,5 Konstantinos I Gourgoulianis3 1Department of Nursing, Technological Educational Institute of Crete, Heraklion, Greece; 2School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, England; 3Respiratory Medicine Department, Medical School, University of Thessaly, Larissa, Greece; 4Department of Thoracic Medicine, Medical School, University of Crete, Heraklion, Greece; 5Department of Medical Laboratories, Technological Educational Institute of Thessaly, Larissa, GreeceBackground: Both airflow limitation and obstructive sleep apnea-hypopnea syndrome (OSAHS)-related symptoms are most prevalent in the elderly population. Previous studies revealed significant associations between OSAHS-related symptoms and obstructive airway diseases in the general population. However, other studies showed that the frequency of OSAHS-related symptoms in patients with obstructive airway diseases decreases after the age of 60 and older.Aims: To investigate the prevalence of OSAHS-related symptoms (snoring, breathing pauses, and excessive daytime sleepiness [EDS]) and their relations to airflow limitation, for people over 65 years old.Methods: A full screening spirometry program was performed in a total of 490 aging participants (mean age 77.5 years – range 65–98) who were attending 16 home care settings in central Greece. Airflow limitation was assessed according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) spirometric criteria (FEV1/FVC ,70%). The Berlin Questionnaire and the Epworth Sleepiness Scale were used to screen individuals for OSAHS-related symptoms. Bivariate associations were described using odds ratio (OR) with 95% confidence intervals (CI).Results: Airflow limitation prevalence was 17.1% (male 24.2% and female 9.9%) and was strongly related to male gender and smoking status. The prevalence rates of frequent snoring, breathing pauses, and EDS were 28.1%, 12.9%, and 11.6%, respectively. However, participants with airflow limitation were less likely to report breathing pauses, frequent snoring, EDS, and obesity. Finally, frequent snoring was significantly more common in males than females.Conclusion: This study revealed decreased frequency of OSAHS-related symptoms in participants with airflow limitation suggesting that OSAHS-related symptoms and airflow limitation are not related in our elderly population.Keywords: sleep apnea syndrome, obstructive airway diseases, excessive daytime sleepiness, snoring